Clinical trial NCT03875872: Comparison of Postoperative Outcomes Between Surgeries Anaesthetized With Propofol and Inhalational Anaesthetics
Official title: Comparison of Postoperative Outcomes Between Surgeries Anaesthetized With Propofol and Inhalational Anaesthetics With Regression Controls for Confounders
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Pain
Keywords: propofol, inhalation anaesthetics, postoperative outcomes, regression control
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
First posted: 2019-03-15
Enrollment: 3922
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: OTHER
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Surgical and anaesthetic data in years 2015-17 from the Acute Pain Service records of Queen Mary Hospital are included for analysis. Available data are about 6000 surgical cases. Only general anaesthesia by propofol or inhalational anaesthetics are included.

Brief summary: Propofol used as anaesthesia in surgery had shown small postoperative analgesic benefits over inhalational anaesthetics in some meta-analyses. It was also associated with reduced risk of postoperative nausea and vomiting. Small sample of studies together with high heterogeneity prevented some meta-analyses to confirm propofol's effect for postoperative morphine consumption and other outcomes. Acute Pain Service data bank can provide an alternative way of evaluating postoperative outcomes of propofol anaesthetics through supplying a very large sample size in a more homogeneous setting. Retrospective study comparing propofol and inhalational anaesthetics on postoperative pain matched on patients' demographic and clinical data had been done for liver surgery. Propofol's benefits for postoperative pain and morphine consumption was confirmed but not for adverse effects.

This study plans to analyze the postoperative outcome data from an Acute Pain Service data bank in years 2015-17 to compare the anaesthetics of propofol and inhalational anaesthetics. Comprehensive regression adjustment for confounders are performed using all available patients' demographic, clinical and anaesthetic data. All major surgery types are included. Results will provide postoperative outcome differences between propofol and inhalational anaesthetics for all surgeries and for specific type of surgeries. The large sample bank will provide higher probability for detecting outcome difference between the anaesthetics for all the major surgical types.

Detailed description: Objective: To compare the postoperative outcomes between surgeries anaesthetized with propofol and inhalational anaesthetics in the Acute Pain Service records of Queen Mary Hospital for years 2015-17

Methods:

Retrospective

Data collection

1. Demographic data;
2. Type of surgery;
3. Type of anaesthetic techniques;
4. Postoperative NRS pain scores (Rest and Moving) for Postop Days 1, 2 \& 3;
5. Accumulated amount of patient controlled analgesia (PCA) used in Postop Days 1, 2 \& 3;
6. Postoperative incidence of nausea, vomitting, dizziness and pruritus.

Eligibility criteria: Inclusion Criteria:

1. Postoperative outcomes from Acute Pain Service data bank between Jan 2015 and Dec 2017 in Queen Mary Hospital would be retrieved;
2. Surgeries with general anaesthesia by either propofol or inhalational anaesthetics.

Exclusion Criteria:

1. Essential data missed;
2. Surgical types with small sample size below 30 for the data collection period.

Primary outcomes:
measure: pain score
timeFrame: up to postoperative day 3
Secondary outcomes:
measure: analgesic consumption
timeFrame: up to postoperative day 3
measure: Amount of patients with adverse events in post-operation
timeFrame: up to postoperative day 3
Other outcomes:
Locations:
city: Hong Kong
country: Hong Kong
facility: The University of Hong Kong
Study officials:
affiliation: The University of Hong Kong
name: Stanley SC Wong, MBBS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Qiu Q, Choi SW, Wong SS, Irwin MG, Cheung CW. Effects of intra-operative maintenance of general anaesthesia with propofol on postoperative pain outcomes - a systematic review and meta-analysis. Anaesthesia. 2016 Oct;71(10):1222-33. doi: 10.1111/anae.13578. Epub 2016 Aug 10.
citation: Peng K, Liu HY, Wu SR, Liu H, Zhang ZC, Ji FH. Does Propofol Anesthesia Lead to Less Postoperative Pain Compared With Inhalational Anesthesia?: A Systematic Review and Meta-analysis. Anesth Analg. 2016 Oct;123(4):846-58. doi: 10.1213/ANE.0000000000001504.
citation: Kumar G, Stendall C, Mistry R, Gurusamy K, Walker D. A comparison of total intravenous anaesthesia using propofol with sevoflurane or desflurane in ambulatory surgery: systematic review and meta-analysis. Anaesthesia. 2014 Oct;69(10):1138-50. doi: 10.1111/anae.12713. Epub 2014 May 22.
citation: Chan AC, Qiu Q, Choi SW, Wong SS, Chan AC, Irwin MG, Cheung CW. Effects of Intra-Operative Total Intravenous Anaesthesia with Propofol versus Inhalational Anaesthesia with Sevoflurane on Post-Operative Pain in Liver Surgery: A Retrospective Case-Control Study. PLoS One. 2016 Feb 22;11(2):e0149753. doi: 10.1371/journal.pone.0149753. eCollection 2016.
citation: Wong SSC, Choi EKY, Chan WS, Cheung CW. Propofol total intravenous anaesthesia versus inhalational anaesthesia for acute postoperative pain in patients with morphine patient-controlled analgesia: a large-scale retrospective study with covariate adjustment. BMC Anesthesiol. 2022 May 10;22(1):140. doi: 10.1186/s12871-022-01683-9.