Zhi-Peng Zhong, Yu Gao, Cheng Fan, Xue Bai, Hao Luo, Lei Zhang, Vivian-Min Yuen, Ying-Yi Xu, Xing-Rong Song, Bi-Lian Li
{"title":"异丙酚与七氟醚麻醉对小儿腺扁桃体切除术后急性疼痛的控制:一项随机对照试验。","authors":"Zhi-Peng Zhong, Yu Gao, Cheng Fan, Xue Bai, Hao Luo, Lei Zhang, Vivian-Min Yuen, Ying-Yi Xu, Xing-Rong Song, Bi-Lian Li","doi":"10.1111/pan.70047","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pain following pediatric adenotonsillectomy is prevalent, frequently severe, and often inadequately managed. The effectiveness of propofol or sevoflurane anesthesia in acute postoperative pain management is unknown.</p><p><strong>Methods: </strong>We conducted a single-blind, randomized controlled trial to examine the postoperative analgesic effectiveness of propofol or sevoflurane anesthesia. 144 children aged 2-7 years were enrolled and randomly assigned to receive either propofol or sevoflurane anesthesia, with 142 completing the study. The primary outcome was the proportion of acute postoperative pain measured by the Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores > 3 within 24 h between the two groups. Secondary outcomes included postoperative pain assessed by the parent's postoperative pain measure (PPPM) scale and numeric rating scale (NRS) on the 1, 2, 3, 7, and 14 postoperative days, as well as perioperative adverse events.</p><p><strong>Results: </strong>The incidence of acute pain FLACC > 3 within 24 h showed comparable results between both groups (30 of 71 [42.3%] vs. 34 of 71 [47.9%]; odds ratio [OR] = 0.78, 95% confidence interval [CI]: [0.28, 2.18]; p = 0.500). The propofol group demonstrated higher pain scores on postoperative days 2-3, with between-group median differences (ΔNRS at activity = 1, ΔPPPM = 1) below minimal clinically important difference thresholds (ΔNRS > 1, ΔPPPM > 3).</p><p><strong>Conclusions: </strong>The incidence and intensity of acute postoperative pain in the first 24 h after adenotonsillectomy did not differ significantly between pediatric patients who received maintenance anesthesia with propofol or with sevoflurane. The two general anesthesia techniques exhibited comparable clinical efficacy with respect to pain prognosis within 2 weeks.</p><p><strong>Trial registration: </strong>The Chinese Clinical Trial Registry (ChiCTR2300075847, Date of registration: September 3, 2023).</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"913-924"},"PeriodicalIF":1.7000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Propofol Versus Sevoflurane Anesthesia for Acute Postoperative Pain Management in Pediatric Adenotonsillectomy: A Randomized Controlled Trial.\",\"authors\":\"Zhi-Peng Zhong, Yu Gao, Cheng Fan, Xue Bai, Hao Luo, Lei Zhang, Vivian-Min Yuen, Ying-Yi Xu, Xing-Rong Song, Bi-Lian Li\",\"doi\":\"10.1111/pan.70047\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pain following pediatric adenotonsillectomy is prevalent, frequently severe, and often inadequately managed. The effectiveness of propofol or sevoflurane anesthesia in acute postoperative pain management is unknown.</p><p><strong>Methods: </strong>We conducted a single-blind, randomized controlled trial to examine the postoperative analgesic effectiveness of propofol or sevoflurane anesthesia. 144 children aged 2-7 years were enrolled and randomly assigned to receive either propofol or sevoflurane anesthesia, with 142 completing the study. The primary outcome was the proportion of acute postoperative pain measured by the Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores > 3 within 24 h between the two groups. Secondary outcomes included postoperative pain assessed by the parent's postoperative pain measure (PPPM) scale and numeric rating scale (NRS) on the 1, 2, 3, 7, and 14 postoperative days, as well as perioperative adverse events.</p><p><strong>Results: </strong>The incidence of acute pain FLACC > 3 within 24 h showed comparable results between both groups (30 of 71 [42.3%] vs. 34 of 71 [47.9%]; odds ratio [OR] = 0.78, 95% confidence interval [CI]: [0.28, 2.18]; p = 0.500). The propofol group demonstrated higher pain scores on postoperative days 2-3, with between-group median differences (ΔNRS at activity = 1, ΔPPPM = 1) below minimal clinically important difference thresholds (ΔNRS > 1, ΔPPPM > 3).</p><p><strong>Conclusions: </strong>The incidence and intensity of acute postoperative pain in the first 24 h after adenotonsillectomy did not differ significantly between pediatric patients who received maintenance anesthesia with propofol or with sevoflurane. The two general anesthesia techniques exhibited comparable clinical efficacy with respect to pain prognosis within 2 weeks.</p><p><strong>Trial registration: </strong>The Chinese Clinical Trial Registry (ChiCTR2300075847, Date of registration: September 3, 2023).</p>\",\"PeriodicalId\":19745,\"journal\":{\"name\":\"Pediatric Anesthesia\",\"volume\":\" \",\"pages\":\"913-924\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/pan.70047\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/pan.70047","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Propofol Versus Sevoflurane Anesthesia for Acute Postoperative Pain Management in Pediatric Adenotonsillectomy: A Randomized Controlled Trial.
Background: Pain following pediatric adenotonsillectomy is prevalent, frequently severe, and often inadequately managed. The effectiveness of propofol or sevoflurane anesthesia in acute postoperative pain management is unknown.
Methods: We conducted a single-blind, randomized controlled trial to examine the postoperative analgesic effectiveness of propofol or sevoflurane anesthesia. 144 children aged 2-7 years were enrolled and randomly assigned to receive either propofol or sevoflurane anesthesia, with 142 completing the study. The primary outcome was the proportion of acute postoperative pain measured by the Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores > 3 within 24 h between the two groups. Secondary outcomes included postoperative pain assessed by the parent's postoperative pain measure (PPPM) scale and numeric rating scale (NRS) on the 1, 2, 3, 7, and 14 postoperative days, as well as perioperative adverse events.
Results: The incidence of acute pain FLACC > 3 within 24 h showed comparable results between both groups (30 of 71 [42.3%] vs. 34 of 71 [47.9%]; odds ratio [OR] = 0.78, 95% confidence interval [CI]: [0.28, 2.18]; p = 0.500). The propofol group demonstrated higher pain scores on postoperative days 2-3, with between-group median differences (ΔNRS at activity = 1, ΔPPPM = 1) below minimal clinically important difference thresholds (ΔNRS > 1, ΔPPPM > 3).
Conclusions: The incidence and intensity of acute postoperative pain in the first 24 h after adenotonsillectomy did not differ significantly between pediatric patients who received maintenance anesthesia with propofol or with sevoflurane. The two general anesthesia techniques exhibited comparable clinical efficacy with respect to pain prognosis within 2 weeks.
Trial registration: The Chinese Clinical Trial Registry (ChiCTR2300075847, Date of registration: September 3, 2023).
期刊介绍:
Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.