Effects of Additional Intraoperative Administration of Sufentanil on Postoperative Pain, Stress and Inflammatory Responses in Patients Undergoing Laparoscopic Myomectomy: A Double-Blind, Randomized, Placebo-Controlled Trial

Abstract

Lian Liu,1 Bingyu Li,1 Quan Cao,2 Bo Zhao,1 Wenwei Gao,3 Yuan Chen,4 Shihua Yu5 1Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People’s Republic of China; 2Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People’s Republic of China; 3Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People’s Republic of China; 4Department of Academic Research, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People’s Republic of China; 5Department of Anesthesiology, Renmin Hospital of Hannan District, Wuhan, Hubei 430090, People’s Republic of ChinaCorrespondence: Yuan ChenDepartment of Academic Research, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People’s Republic of ChinaEmail [email protected] YuDepartment of Anesthesiology, Renmin Hospital of Hannan District, Wuhan, Hubei 430090, People’s Republic of ChinaEmail [email protected]: Although pain after laparoscopic surgery is assumed to be minor, many women still suffer from unexpected postoperative pain. Thus, we aimed to assess whether additional intraoperative administration of sufentanil could help to improve postoperative pain and related agitation, stress, and inflammation response in patients undergoing laparoscopic myomectomy.Patients and Methods: Forty female patients with uterine myoma scheduled for laparoscopic myomectomy under general anesthesia were randomized to receive sufentanil (group T, n=20) or normal saline (group C, n=20) 1h before the end of the surgery. The postoperative pain, agitation, stress, inflammation, and adverse effects were measured.Results: As the primary outcome, the visual analog scale (VAS) pain score was significantly reduced in group T as compared with group C at each measured time point in a post-anesthesia care unit (PACU), VAS 5 min (31.5 ± 2.7 vs 40.6 ± 5.6) (P< 0.001), VAS 30 min (36.5 ± 4.5 vs 46.0 ± 2.9) (P< 0.001), VAS 1h (37.8 ± 4.0 vs 48.6 ± 5.5) (P< 0.001). The secondary outcomes, including the sedation agitation scale (SAS) scores, plasma concentrations of epinephrine and norepinephrine, and the levels of plasma interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) in group T were remarkably lower than those in group C (P < 0.001). The cough cases in group T also showed a significant reduction in comparison with group C (P < 0.05). In addition, the anesthetic recovery time, including the spontaneous breathing recovery time and extubation time, were not significantly different between the two groups, as were the cases of respiratory depression and postoperative delirium (P > 0.05).Conclusion: For patients undergoing laparoscopic myomectomy, administration of sufentanil 1 h before the end of surgery shows excellent analgesic and sedative effects, alleviated postoperative stress and inflammatory responses, reduced incidence of cough, without prolonging anesthetic recovery time and increasing adverse reactions.Keywords: anesthesia, laparoscopic myomectomy, postoperative outcomes, sufentanil

Keywords

• anesthesia
• laparoscopic myomectomy
• postoperative outcomes
• sufentanil