Emmanuel Besnier1,2, Anne Perdrix3, André Gillibert4, Jean Selim5,6, Benoit Froëmer5, Antoine Ghemired5, Benoit Berby7,8, Nathalie Rives7,8, Bertrand Dureuil5, Thomas Clavier5,6, Vincent Compère5,9. 1. Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76031, Rouen Cedex, France. Emmanuel.besnier@chu-rouen.fr. 2. Normandie University, UNIROUEN, INSERM, Rouen, U1096, France. Emmanuel.besnier@chu-rouen.fr. 3. Department of Biopathology, Clinical Laboratory, Henri Becquerel Centre, Rouen, France. 4. Department of Biostatistics, Rouen University Hospital, Rouen, France. 5. Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76031, Rouen Cedex, France. 6. Normandie University, UNIROUEN, INSERM, Rouen, U1096, France. 7. Gametogénèse et Qualité du Gamète, Rouen University Hospital, Rouen, France. 8. Laboratoire de Biologie de la Reproduction-CECOS, Rouen University Hospital, Rouen, France. 9. Normandie University, UNIROUEN, INSERM, Rouen, U1239, France.
Abstract
PURPOSE: Previous preclinical and preliminary clinical data suggest an appetite-stimulating effect of propofol compared with halogenated drugs. This study compared the effects of propofol with those of sevoflurane on recovery of hunger during the postoperative period. METHODS:Patients undergoing outpatient transvaginal oocyte retrieval were randomized to propofol-remifentanil (propofol group) or sevoflurane-remifentanil (sevoflurane group) anesthesia. The primary endpoint was the time before feeling hungry (≥ 50/100 mm on a visual analogue scale). Secondary endpoints included plasma levels of ghrelin, leptin, and insulin (ten minutes, one hour, and two hours after anesthesia), caloric intake at first feed, and discharge readiness time. RESULTS: In the 58 patients allocated to either the propofol or sevoflurane group, there was no difference in the median [interquartile range] recovery time of hunger (97 [75-138] vs 97 [80-140] min, respectively; median difference, 1; 95% confidence interval [CI], - 15 to 14; P = 0.91); caloric intake (245 [200-343] vs 260 [171-314] kcal; P = 0.39); or discharge readiness time (125 [85-153] vs 125 [95-174] min, P = 0.29). The groups showed no difference in crude plasma levels of ghrelin, leptin, and insulin at any time-point. When peptide plasma levels were expressed as a % change from baseline, there was a higher insulin plasma level one hour after anesthesia in the sevoflurane group (median difference, 4.9%; 95% CI, - 16.2 to 43.4) compared with the propofol group (median difference, - 21.2%; 95% CI, - 35.7 to 9.1; adjusted P = 0.01). CONCLUSION:Propofol did not accelerate the recovery of hunger compared with sevoflurane after outpatient minor surgery. Moreover, propofol did not have distinguishable effects on other clinical or biological parameters associated with food intake. TRIAL REGISTRATION: www.ClinicalTrials.gov (NCT02272166); registered 22 October, 2014.
RCT Entities:
PURPOSE: Previous preclinical and preliminary clinical data suggest an appetite-stimulating effect of propofol compared with halogenated drugs. This study compared the effects of propofol with those of sevoflurane on recovery of hunger during the postoperative period. METHODS:Patients undergoing outpatient transvaginal oocyte retrieval were randomized to propofol-remifentanil (propofol group) or sevoflurane-remifentanil (sevoflurane group) anesthesia. The primary endpoint was the time before feeling hungry (≥ 50/100 mm on a visual analogue scale). Secondary endpoints included plasma levels of ghrelin, leptin, and insulin (ten minutes, one hour, and two hours after anesthesia), caloric intake at first feed, and discharge readiness time. RESULTS: In the 58 patients allocated to either the propofol or sevoflurane group, there was no difference in the median [interquartile range] recovery time of hunger (97 [75-138] vs 97 [80-140] min, respectively; median difference, 1; 95% confidence interval [CI], - 15 to 14; P = 0.91); caloric intake (245 [200-343] vs 260 [171-314] kcal; P = 0.39); or discharge readiness time (125 [85-153] vs 125 [95-174] min, P = 0.29). The groups showed no difference in crude plasma levels of ghrelin, leptin, and insulin at any time-point. When peptide plasma levels were expressed as a % change from baseline, there was a higher insulin plasma level one hour after anesthesia in the sevoflurane group (median difference, 4.9%; 95% CI, - 16.2 to 43.4) compared with the propofol group (median difference, - 21.2%; 95% CI, - 35.7 to 9.1; adjusted P = 0.01). CONCLUSION:Propofol did not accelerate the recovery of hunger compared with sevoflurane after outpatient minor surgery. Moreover, propofol did not have distinguishable effects on other clinical or biological parameters associated with food intake. TRIAL REGISTRATION: www.ClinicalTrials.gov (NCT02272166); registered 22 October, 2014.
Authors: A M Wren; L J Seal; M A Cohen; A E Brynes; G S Frost; K G Murphy; W S Dhillo; M A Ghatei; S R Bloom Journal: J Clin Endocrinol Metab Date: 2001-12 Impact factor: 5.958
Authors: Manfred Eggersdorfer; Ucheoma Akobundu; Regan L Bailey; Julie Shlisky; Amy R Beaudreault; Gilles Bergeron; Robert B Blancato; Jeffrey B Blumberg; Megan W Bourassa; Filomena Gomes; Gordon Jensen; Mary Ann Johnson; Douglas Mackay; Keri Marshall; Simin Nikbin Meydani; Katherine L Tucker Journal: Nutrients Date: 2018-09-01 Impact factor: 5.717