Currently, total intravenous anesthesia (TIVA) and inhaled anesthesia are both commonly used for transsphenoidal pituitary adenoma resection. However, optimal choice for anesthesia maintenance in transsphenoidal surgery remains unclear. Previous studies focusing on this question provided fragmentary assessment and controversial results. The goal of this clinical trial is to investigate whether propofol and sevoflurane have different effect on post-anesthetic recovery after transsphenoidal resection of pituitary adenoma.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
252
Anesthesia is maintained with inhalation of sevoflurane. The concentration of sevoflurane was adjusted to maintain anesthetic depth, aiming for a bispectral index of 40-60.
Anesthesia is maintained with an effect-site target-controlled infusion of propofol (2-6ug/ml) based on the Marsh mode. The concentration of propofol was adjusted to maintain anesthetic depth, aiming for a bispectral index of 40-60.
Peking Union Medical College Hospital
Beijing, Beijing Municipality, China
15-item quality of recovery score (QoR-15)
The QoR-15 score ranges from 0 to 150 (higher is better). The investigators record the scores of two groups 1 day after the surgery.
Time frame: 24 hours after end of surgery
Time to awake from anesthesia
The time between discontinuing drugs and response to verbal command.
Time frame: From stopping sevoflurane or propofol to awake, approximately 30 minutes
Time to extubation
The time between discontinuing drugs and withdrawal of tracheal tube.
Time frame: From stopping sevoflurane or propofol to recovery of spontaneous breathing and withdrawal of tracheal tube, approximately 30 minutes
Agitation or sedation level during emergence
The highest Richmond agitation and sedation scale score (RASS) during emergence. The RASS score ranges from -5 to +4, and a lower score indicates a more sedative level.
Time frame: From stopping sevoflurane or propofol to complete awakening, approximately 30 minutes
Coughing and bucking during emergence
Coughing score ranges from 0 to 3, and a higher score indicates a severer outcome.The investigators record the highest coughing score during emergence.
Time frame: From stopping sevoflurane or propofol to complete awakening, approximately 30 minutes
Time to discharge from postanesthesia care unit (PACU)
The time between admission into PACU and discharging from PACU with Aldrete score over 9. Aldrete score ranges from 0 to 10, and a higher score indicates a better recovery from anesthesia.
Time frame: From admit into PACU to discharge from PACU, approximately 45 minutes
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PACU antiemetic drug use
The drug use due to postoperative nausea and vomiting in PACU.
Time frame: From admit into PACU to discharge from PACU, approximately 45 minutes
PACU analgesic drug use
The drug use due to postoperative pain in PACU.
Time frame: From admit into PACU to discharge from PACU, approximately 45 minutes
Post operative nausea and vomiting score
Score: 0, no nausea and vomiting; 1-4, mild nausea and vomiting; 5-6, moderate nausea and vomiting; 7-10, severe nausea and vomiting.
Time frame: 24 hours after end of surgery
Concentration of serum adrenocorticotropic hormone (ACTH)
The investigators examine the serum level of ACTH in pg/mL.
Time frame: 24 hours after end of surgery
Concentration of serum cortisol
The investigators examine the serum level of cortisol in ug/dL.
Time frame: 24 hours after end of surgery
Concentration of serum thyroid-stimulating hormone (TSH)
The investigators examine the serum level of TSH in uIU/mL.
Time frame: 24 hours after end of surgery
Concentration of serum growth hormone (GH)
The investigators examine the serum level of GH in ng/mL.
Time frame: 24 hours after end of surgery
Concentration of serum gonadotrophin
The investigators examine the serum level of gonadotrophin in IU/L.
Time frame: 24 hours after end of surgery
Concentration of serum prolactin (PRL)
The investigators examine the serum level of PRL ng/mL.
Time frame: 24 hours after end of surgery
Counts of peripheral blood lymphocyte
Time frame: 24 hours after end of surgery
Incidence of hypotension during anesthesia
Hypotension is defined as decrease of mean arterial pressure (MAP) more than 20% of baseline.
Time frame: From start of surgery to end of surgery, on an average of 2 hours
Incidence of hypertension during anesthesia
Hypertension is defined as increase of MAP more than 20% of baseline.
Time frame: From start of surgery to end of surgery, on an average of 2 hours
Time to discharge from hospital
The time between end of surgery and discharge from hospital.
Time frame: From end of surgery to discharge from hospital, on an average of 2 days