A randomized controlled trial of propofol-remifentanil total intravenous anesthesia and sevoflurane-fentanyl anesthesia on early postoperative fatigue in patients undergoing laparoscopic colorectal surgery
- Authors
- Lee, Seungwon; Woo, Seunghyeon; Oh, Eun Jung; Park, MiHye
- Issue Date
- Jan-2024
- Publisher
- Springer Science and Business Media Deutschland GmbH
- Keywords
- Colorectal surgery; Fatigue; General anesthesia; Propofol; Sevoflurane
- Citation
- Quality of Life Research, v.33, no.1, pp 241 - 252
- Pages
- 12
- Journal Title
- Quality of Life Research
- Volume
- 33
- Number
- 1
- Start Page
- 241
- End Page
- 252
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74304
- DOI
- 10.1007/s11136-023-03510-1
- ISSN
- 0962-9343
1573-2649
- Abstract
- Purpose: Even after uncomplicated surgery, postoperative fatigue prevalence has been reported to be 30–80% for various surgeries. We evaluated postoperative fatigue according to anesthetic technique in patients who underwent colorectal surgery. Methods: One hundred thirty patients who underwent colorectal surgery were randomly assigned to either propofol-remifentanil total intravenous anesthesia (propofol-remifentanil group, n = 65) or sevoflurane-fentanyl anesthesia (sevoflurane-fentanyl group, n = 65). The primary outcome was the prevalence of postoperative fatigue, as defined by the Chalder Fatigue Questionnaire (total score ≥ 16), at 24 h postoperatively. Secondary outcomes were early postoperative complications during hospitalization and laboratory examination. Results: The final analyses included 127 patients. The prevalence of postoperative fatigue on the 1st postoperative day was lower in the propofol-remifentanil group than the sevoflurane-fentanyl group: 56.3% (36/64) in the propofol-remifentanil group and 73.0% (46/63) in the sevoflurane-fentanyl group (relative risk [RR] = 0.77, 95% confidence interval [CI] 0.59–1.00; P = 0.048). However, there was no difference between the two groups in postoperative fatigue at postoperative day 3. Other postoperative outcomes including the severity of pain and the incidence of nausea/vomiting were not different between the two groups, but postoperative atelectasis on chest X-ray was higher in the sevoflurane-fentanyl group (2/64 [3.1%] vs. 9/63 [14.3%], P = 0.025). C-reactive protein change from preoperative to postoperative day 1 and 5 was significantly lower in the propofol-remifentanil group (P = 0.044). Conclusion: Propofol-remifentanil total intravenous anesthesia was associated with reduced postoperative fatigue at the 1st postoperative day compared with sevoflurane-fentanyl anesthesia. Clinical trial The Korean Clinical Research Registry (study identifier: KCT0006917, principal investigator’s name: MiHye Park, date of registration: January 12, 2022). © 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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