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Comparison of the effects of inhalational and total intravenous anesthesia on quality of recovery in patients undergoing endoscopic transsphenoidal pituitary surgery: a randomized controlled trial

Authors
 Do-Hyeong Kim  ;  Kyeong Tae Min  ;  Eui Hyun Kim  ;  Young Seo Choi  ;  Seung Ho Choi 
Citation
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, Vol.19(6) : 1056-1064, 2022-06 
Journal Title
INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
Issue Date
2022-06
MeSH
Anesthesia, Intravenous / methods ; Anesthetics, Inhalation* ; Anesthetics, Intravenous ; Emergence Delirium* / drug therapy ; Humans ; Propofol* ; Remifentanil ; Sevoflurane
Keywords
inhalational anesthesia ; intravenous anesthesia ; pituitary surgery ; postoperative recovery
Abstract
Background: Endoscopic transsphenoidal pituitary surgery has shown promising results. However, fast and high-quality recovery after this procedure remains a challenge for neuroanesthesiologists. This study aimed to compare the quality of recovery after transsphenoidal pituitary surgery between patients who received inhalational anesthesia with sevoflurane and patients who received propofol-based total intravenous anesthesia (TIVA). Methods: Eighty-two patients undergoing transsphenoidal pituitary surgery were randomized to receive either sevoflurane inhalation with manual infusion of remifentanil (sevoflurane group) or effect-site target-controlled infusion of propofol and remifentanil (TIVA group). The primary outcome was the 40-item Quality of Recovery (QoR-40) score on postoperative day 1. The QoR-40 questionnaire was completed by patients the day before surgery and on postoperative days 1 and 2. Emergence agitation and recovery characteristics were also assessed. Results: There were no significant differences between the groups in the global QoR-40 scores on both postoperative days 1 and 2 (difference -8.7, 95% CI -18.0 to 0.7, and P = 0.204; -3.6, 95% CI -13.0 to 5.8, and P > 0.999, respectively). The time to verbal response and time to extubation were significantly shorter in the sevoflurane group than in the TIVA group (P < 0.001 and P < 0.001, respectively). However, the incidence of emergence agitation was lower in the TIVA group than in the sevoflurane group (P < 0.001). Conclusions: Both inhalational anesthesia with sevoflurane and propofol-based TIVA were appropriate anesthetic techniques for patients undergoing endoscopic transsphenoidal pituitary surgery in terms of the quality of recovery up to 2 days postoperatively. Rapid emergence was observed in the sevoflurane group, while smooth emergence was observed in the TIVA group.
Files in This Item:
T202202350.pdf Download
DOI
10.7150/ijms.72758
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Min, Kyeong Tae(민경태) ORCID logo https://orcid.org/0000-0002-3299-4500
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189384
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