A randomised controlled trial of propofol vs. thiopentone and desflurane for fatigue after laparoscopic cholecystectomy

Abstract

Fatigue may delay functional recovery after day surgery and may be more common after propofol anaesthesia. We randomly allocated 123 participants scheduled for ambulatory laparoscopic cholecystectomy to induction and maintenance of general anaesthesia with propofol or thiopentone and desflurane. Postoperative fatigue was unaffected by the allocated anaesthetic. The combined mean (SD) Identity-Consequences Fatigue Scale of 34.3 (15.1) before surgery increased in the first postoperative week: to 60.4 (21.1) on day 1, p < 0.001; to 51.1 (17.2) on day 2, p < 0.001; and to 37.5 (16.3) on day 6, p = 0.028. The mean (SD) fatigue reduced at one postoperative month to 22.4 (12.6), 35% less than the combined pre-operative level, p < 0.001. Rates of nausea, vomiting and rescue antie-mesis during the first week after propofol, compared with thiopentone and desflurane, were: 23/63 vs. 32/60, p = 0.27; 8/63 vs. 9/60, p = 0.71; and 12/63 vs. 28/60, p = 0.001, respectively. There were no differences in postoperative pain. In conclusion, fatigue after scheduled laparoscopic cholecystectomy was unaffected by anaesthesia with propofol vs. thiopentone and desflurane.

Colecistectomía laparoscópica ambulatoria, una realidad actual

“…La cirugía mayor, con un traumatismo tisular extenso e inflamación, se asocia con una mayor fatiga inicial que la cirugía menor. En definitiva, la fatiga después de la colecistectomía laparoscópica programada no se vio afectada por la anestesia con Propofol frente a tiopental y desflurano (14).…”

Defining the cut-off point of clinically significant postoperative fatigue in three common fatigue scales

“…The data in the present study have been collected as part of two previously published fatigue-related studies from our research group; a validation study in a mixed day surgery population [22], and a randomised controlled trial (RCT) on fatigue after laparoscopic cholecystectomy [24]. For the present analyses, data from the two studies were combined.…”

“…Comparison of fatigue after laparoscopic (lap.) or open cholecystectomy measured with ChrFS ; from Hill[11] and Nostdahl[24]. Values are mean (SD).…”