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.

中文翻译：

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门诊手术后接受异丙酚与七氟醚麻醉的患者术后饥饿感：一项随机对照试验。

目的先前的临床前和初步临床数据表明，与卤代药物相比，丙泊酚具有食欲刺激作用。这项研究比较了异丙酚和七氟醚对术后恢复饥饿的影响。方法将门诊经阴道卵母细胞取出的患者随机分为丙泊酚-瑞芬太尼（丙泊酚组）或七氟醚-瑞芬太尼（七氟醚组）麻醉。主要终点是感到饥饿之前的时间（在视觉模拟标度上≥50/100 mm）。次要终点包括生长素释放肽，瘦素和胰岛素的血浆水平（麻醉后十分钟，一小时和两小时），第一次进食时的热量摄入和出院准备时间。结果在分配给异丙酚或七氟醚组的58例患者中，饥饿的中位[四分位数间距]恢复时间没有差异（分别为97 [75-138]分钟和97 [80-140]分钟；中位数差异为1； 95％置信区间[CI]，介于15至14之间; P = 0.91）; 卡路里摄入量（245 [200-343] vs 260 [171-314] kcal； P = 0.39）；或放电准备时间（125 [85-153]分钟相对于125 [95-174]分钟，P = 0.29）。这些组在任何时间点的生长素释放肽，瘦素和胰岛素的粗血浆水平均无差异。当将肽血浆水平表示为相对于基线的变化百分比时，与丙泊酚组相比，七氟醚组麻醉后一小时的胰岛素血浆水平较高（中位数差异为4.9％； 95％CI为-16.2至43.4）（中位数差异-21.2％； 95％CI-35.7-9.1；调整后的P = 0.01）。结论与七氟醚相比，在门诊患者进行小手术后，异丙酚没有促进饥饿的恢复。此外，丙泊酚对与食物摄入有关的其他临床或生物学参数没有明显的影响。试用注册www.ClinicalTrials.gov（NCT02272166）; 于2014年10月22日注册。