Postoperative Analgesia in Children After Propofol Versus Sevoflurane Anesthesia

Abstract

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 40mg/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. © 2013 American Academy of Pain Medicine.