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The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery
Author(s) -
Desmet M.,
Vander Cruyssen P.,
Pottel H.,
Carlier S.,
Devriendt D.,
Van Rooy F.,
De Corte W.
Publication year - 2016
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12675
Subject(s) - remifentanil , medicine , propofol , sevoflurane , anesthesia , bispectral index , peristalsis , desflurane , randomized controlled trial , surgery , laparoscopic surgery , laparoscopy
Background Volatile anaesthetics have an influence on small bowel peristalsis during laparoscopic surgery. A recent study concluded that desflurane increased intestinal motility compared to sevoflurane. Hence, a desflurane‐based anaesthesia protocol may reduce surgical exposure during intestinal suturing or stapling due to small bowel hyperperistalsis. The effect of propofol on intestinal motility is not well studied. We tested the hypothesis that a propofol–remifentanil anaesthesia increases intestinal contractions in comparison with a sevoflurane–remifentanil anaesthesia. Methods Patients scheduled for laparoscopic gastric bypass surgery were randomized in this single blind randomized controlled trial to receive remifentanil combined with sevoflurane or propofol (ISRCTN 12921661). Bispectral index monitoring was used to guide depth of anaesthesia. Visual observation of peristaltic waves was performed during 1 min at the planned site of the jejunostomy. Statistical analysis was performed using Wilcoxon two‐sample test. Results After obtaining written informed consent 50 patients were included. Groups were similar for demographic variables, and depth of anaesthesia during the observations. The median number of peristaltic waves was lower in the sevoflurane–remifentanil group compared to the propofol–remifentanil group (0 vs. 6, P < 0.001). Conclusion Propofol–remifentanil increases intestinal motility compared with sevoflurane–remifentanil during laparoscopic gastric bypass surgery. A sevoflurane‐based protocol can help to avoid disturbing peristalsis.