Postoperative Analgesia in Children After Propofol Versus Sevoflurane Anesthesia

• Published in: Pain medicine (Malden, Mass.) Vol. 14; no. 3; pp. 442 - 446
• Main Authors: Hasani, Antigona, Gecaj‐Gashi, Agreta, Llullaku, Sadik, Jashari, Hysni
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2013
• Subjects: Anesthesia Recovery Period; Anesthesia, General - methods; Anesthetics, General - therapeutic use; Child; Child, Preschool; Children; Double-Blind Method; Drug Therapy, Combination; Female; Fentanyl - therapeutic use; Herniorrhaphy - methods; Hospitals, University; Humans; Male; Methyl Ethers - therapeutic use; Pain Measurement; Pain, Postoperative - prevention & control; Postoperative Analgesia; Propofol; Propofol - therapeutic use; Sevoflurane
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1111/pme.12031

Objective. Postoperative analgesia remains a problem, especially in pediatric patients. We hypothesize that patients anesthetized with sevoflurane have more postoperative pain than with propofol. Design. Randomized, prospective, double‐blind study. Setting. University teaching hospital. Subjects. The subjects were 88 premedicated children, aged 3–6 years, and American Society of Anesthesiologists (ASA) Physical Status I or II. Interventions. Subjectsunderwent hernia repair surgery. Methods. Anesthesia was maintained with propofol (group P, N = 46) or sevoflurane (group S, N = 42) and fentanyl was administered during surgery. All children before surgical incision received 40 mg/kg paracetamol, rectally. Prior to wound closure, the margins were infiltrated with 0.5% bupivacaine. Outcome Measures. The primary outcome was pain score assessed by Faces Pain Scale (FPS) 2 hours postoperatively. The secondary outcomes included recovery time and adverse events within the first 2 hours. Results. Group S had a significantly higher proportion of patients who exhibited postoperative pain than group P (24.3% vs 4.5%, respectively; P < 0.05). FPS score in group P was 1.2 ± 0.6, compared with 3.4 ± 1.5 in group S (P < 0.001). Mean recovery time in group S was significantly shorter than the corresponding mean for group P (10.1 ± 1.3 vs 16.5 ± 5.4 minutes, respectively; P < 0.001). Conclusion. In children, anesthesia maintenance with propofol was associated with a significantly lower incidence of postoperative pain than with sevoflurane.