Propofol versus Sevoflurane for Postoperative Pain following Open Cholecystectomy: A Randomised Controlled Trial

Abstract

Postoperative pain (POP) remains a common challenge following open cholecystectomy (OC). In Libya, survey data report that more than 50% of patients experience significant pain within 24 hours, highlighting a critical need for improved analgesic strategies. As a key factor hindering recovery, effective pain management is essential. This randomized controlled trial evaluated whether propofol-based total intravenous anaesthesia (TIVA) reduces early POP compared to standard inhalational techniques in this population. A prospective, double-blind, randomised controlled trial enrolled 80 patients undergoing OC. POP intensity was quantified by applying the numerical rating scale (NRS) at 2-, 6-, 12-, and 24-hour intervals following surgery. Statistical analyses were conducted with SPSS version 26. Between-group comparisons using independent t-tests and one-way ANOVA indicated that participants receiving propofol-based TIVA exhibited significantly reduced pain scores at 2, 6, and 12 hours postoperatively relative to the sevoflurane-based inhalational anaesthesia (IA) group (p < 0.05). However, no statistically significant intergroup difference was observed at the 24-hour assessment (p > 0.05). This pattern suggests that the analgesic advantage of propofol TIVA is predominantly evident during the immediate postoperative period. At 24 hours postoperatively, propofol TIVA did not confer superior analgesic efficacy compared with sevoflurane IA in patients undergoing OC. Consequently, these results do not endorse propofol TIVA as the preferred anaesthetic strategy for attenuating POP in this surgical context.