Patient well-being after general anaesthesia: a prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia

Hofer, Christoph K.; Zollinger, Andreas; Büchi, Stefan; Klaghofer, Richard; Serafino, D; Bühlmann, S.; Buddeberg, Claus; Pasch, Th.; Spahn, Donat R.

doi:10.1093/bja/aeg243

Cited by 105 publications

(75 citation statements)

References 22 publications

(11 reference statements)

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“…A total of 13 trials reported pain intensity at or around 2 h postsurgery, in which 686 patients received anaesthesia using propofol for maintenance, while 668 were given inhalational anaesthesia [10,11,[18][19][20][21][22][23][24][25][26][27][28]. Overall, pain scores were not significantly different between experimental groups (Hedge's g (95%CI) À0.120 (À0.415-0.175) (p = 0.425) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…A total of nine trials reported pain intensity at or around 24 h postsurgery, in which 595 patients received propofol anaesthesia, while 586 had inhalational anaesthesia [10,11,18,19,21,22,25,28,29]. Overall, compared with inhalational anaesthetics, patients who received propofol reported significantly lower pain scores 24 h postsurgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies investigated postoperative nausea and vomiting, with 371 patients receiving propofol and 354 patients receiving inhalational anaesthesia [10,19,20,22,24,25,28,30]. Propofol was associated with a significant reduction in postoperative nausea and vomiting (relative risk (95% CI) 0.446 (0.304-0.656) (p < 0.0001) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Postoperative nausea and vomiting is a common and distressing complication of anaesthesia, with a recently reported incidence of around 30% for [22] 4 (26) 5 9260 0.800 Hocker et al [24] 10 (51) 13 (52) 0.784 Hofer et al [25] 84 (155) 125 (146) 0.633 vomiting and around 50% for nausea [38]. It is also associated with prolonged recovery stay and unexpected hospital admission with subsequent higher health care costs [42].…”

Section: Discussionmentioning

confidence: 99%

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Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

et al. 2016

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SummaryPropofol is used both for induction and maintenance of anaesthesia. Recent evidence shows that propofol has analgesic properties. This meta-analysis evaluated differences in postoperative analgesia between general anaesthetic maintenance with intravenous propofol and inhalational anaesthetics. Fourteen trials met inclusion criteria and were included. Our outcomes were pain scores 2 and 24 h after surgery. No significant difference in pain scores was found at 2 h after surgery (Hedge's g (95% CI) À0.120 (À0.415-0.175) (p = 0.425). Propofol was associated with a statistically significant, albeit marginal, reduction in pain scores 24 h after surgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021). Data were insufficient to allow a meaningful analysis regarding 24-h morphine-equivalent consumption. Propofol was associated with reduced postoperative nausea and vomiting (relative risk (95%CI) 0.446 (0.304-0.656) (p < 0.0001). In conclusion, this meta-analysis suggests that propofol improves postoperative analgesia compared with inhalational anaesthesia 24 h after surgery, with a lower incidence of nausea and vomiting.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

et al. 2016

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“…[70][71][72][73][74] Among eight studies using volatiles, four found acupuncture effective for PONV, 52,54,60 and one found acupuncture effective for vomiting, 6 but not for nausea. One study using intravenous anesthesia found acupuncture effective, 59 and one found it was not effective.…”

Section: Anesthesia As Risk Factor For Ponvmentioning

confidence: 99%

Acupuncture in ambulatory anesthesia: a review

Norheim¹,

Liodden²,

Alræk³

2015

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Background: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting (POVN) and postoperative vomiting (POV) show promising results while many clinicians remain skeptical of the value of acupuncture. Given the interest in finding safe nonpharmacological approaches toward postoperative care, this body of knowledge needs to be considered. This review critically appraises and summarizes the research on acupuncture and acupressure in ambulatory anesthesia during the last 15 years. Methods: Articles were identified through searches of Medline, PubMed, and Embase using the search terms "acupuncture" or "acupuncture therapy" in combination with "ambulatory anesthesia" or "ambulatory surgery" or "day surgery" or "postoperative". A corresponding search was done using "acupressure" and "wristbands". The searches generated a total of 104, 118, and 122 references, respectively. Results: Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. Nine studies found acupuncture or acupressure effective on primary endpoints including postoperative nausea and vomiting, postoperative pain, sore throat, and emergence agitation. Four studies found acupuncture had a similar effect to antiemetic medication. Conclusion: Overall, the studies were of fairly good quality. A large proportion of the reviewed papers highlights an effect of acupuncture or acupressure on postoperative morbidities in an ambulatory setting. However, one should bear in mind that research on acupuncture/acupressure in an ambulatory setting contributes to ambiguous conclusions. Hence, we have addressed some of the issues related to this diversity in acupuncture research.

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Postoperative Übelkeit und Erbrechen

Apfel¹

2005

Evidenzbasierte Medizin in Anästhesie Und Intensivmedizin

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Patient well-being after general anaesthesia: a prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia

Abstract: Total i.v. anaesthesia improves early postoperative patient well-being and reduces the incidence of PONV.

Cited by 105 publications

References 22 publications

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

Acupuncture in ambulatory anesthesia: a review

Postoperative Übelkeit und Erbrechen

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