Journal of Anaesthesiology Clinical Pharmacology

LETTER TO EDITOR
Year
: 2012  |  Volume : 28  |  Issue : 2  |  Page : 265--266

Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A possible misidentified role of propofol


Pierre-Yves Lequeux1, Emily Bui-Quc1, Gilbert Bejjani2,  
1 Department of Anesthesiology, CHU-Tivoli, La Louviere, Belgium
2 Clinique de la Basilique-CHIREC, Brussels, Belgium

Correspondence Address:
Pierre-Yves Lequeux
Avenue Max Buset, 34 - 7100 La Louviere
Belgium




How to cite this article:
Lequeux PY, Bui-Quc E, Bejjani G. Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A possible misidentified role of propofol.J Anaesthesiol Clin Pharmacol 2012;28:265-266


How to cite this URL:
Lequeux PY, Bui-Quc E, Bejjani G. Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A possible misidentified role of propofol. J Anaesthesiol Clin Pharmacol [serial online] 2012 [cited 2021 Feb 28 ];28:265-266
Available from: https://www.joacp.org/text.asp?2012/28/2/265/94919


Full Text

Sir,

We read with interest the article "Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study" by Sahni et al. [1] The authors compared two groups of patients both anesthetized with standardized isoflurane and nitrous oxide anesthesia, in one group supplemental propofol boluses were administered in order to maintain bispectral index (BIS) between 40 and 45. As rescue analgesic requirement was lower in the group with the lower BIS, the authors concluded that maintaining BIS to a value of 45-40 throughout the surgery results in better postoperative pain relief.

However, to draw their conclusions, the authors did not take into consideration the difference in the total amount of propofol administered, which was statistically larger in the group with the lower BIS. Cheng et al. [2] showed that general anesthesia with propofol is associated with less postoperative pain and morphine use than the general anesthesia with isoflurane. The lesser rescue analgesic requirement observed in the low BIS group could have been caused by the larger propofol dose as well. In order to be sure that the better postoperative pain relief was caused only because of a deeper anesthesia, authors should have used isoflurane to deepen anesthesia instead of propofol.

References

1Sahni N, Anand LK, Gombar KK, Gombar S. Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study. J Anaesthesiol Clin Pharmacol 2011;27:500-5
2Cheng SS, Yeh J, Flood P. Anesthesia matters: Patients anesthetized with propofol have less postoperative pain than those anesthetized with isoflurane. Anesth Analg 2008;106:264-9.