Faculty Collaboration Database

Total intravenous versus inhaled anesthesia in transsphenoidal tumor surgery. Am J Otolaryngol 2018;39(5):567-569

Date

07/19/2018

Pubmed ID

30017373

Pubmed Central ID

PMC6105509

DOI

10.1016/j.amjoto.2018.06.018

Scopus ID

2-s2.0-85049731191 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

PURPOSE: Visualization of the surgical field is essential for patient safety during endoscopic transsphenoidal tumor surgery. In this retrospective chart review and data analysis of patients undergoing endoscopic transsphenoidal resection of pituitary tumors under general anesthesia we sought to determine if total intravenous anesthesia with propofol and remifentanil leads to decreased bleeding, surgical duration, time to extubation and/or length of stay in the recovery room compared to inhaled anesthesia with sevoflurane or desflurane.

METHODS: After IRB approval, chart reviews of 193 American Society of Anesthesiologists class 1 to 3 patients were conducted who had undergone transsphenoidal, endonasal resections of pituitary tumors under total intravenous or inhaled anesthesia at an academic teaching hospital in the United States over a seven-year time period. One hundred four patients fulfilled the inclusion criteria and were further reviewed. Primary outcome was intraoperative blood loss; secondary outcomes were surgical duration, time to extubation and length of stay in the recovery room.

RESULTS: Gender, age, and Lund-Mackay-Scores were equally distributed between the two anesthetic groups. We found no significant effect of the anesthetic technique, age, gender, or Lund Mackay score on any of the primary or secondary outcomes. The only significant predictor for recovery room length of stay was intraoperative blood loss.

CONCLUSION: Our study shows no evidence that total intravenous anesthesia is superior to inhaled anesthesia or vice versa during endoscopic transsphenoidal sinus surgery with regard to relevant clinical outcome parameters.

Author List

Gollapudy S, Poetker DM, Sidhu J, Riess ML

Authors

Suneeta Gollapudy MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
David M. Poetker MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Airway Extubation
Analgesics, Opioid
Anesthesia, General
Anesthetics, Inhalation
Anesthetics, Intravenous
Blood Loss, Surgical
Endoscopy
Female
Humans
Length of Stay
Male
Middle Aged
Operative Time
Pituitary Neoplasms
Propofol
Retrospective Studies