Comparison of Propofol Requirement Between Patients With Pituitary Somatotroph Tumor and With Nonfunctioning Pituitary Tumor in Transsphenoidal Pituitary Surgery Under Total Intravenous Anesthesia

Completed

Interventions: Procedure: Not applicable (measuring subject's effect site concentration of propofol during the induction of general anesthesia)

Brief Summary: Investigators hypothesized that propofol dose for pituitary somatotroph patients might differ from nonfunctioning pituitary tumor, and investigators will evaluate a target controlled infusion (TCI) effect site concentration (Ce) of propofol for BIS score of 40 and LOC (loss of consciousness) in pituitary somatotroph patients in comparison with non functioning pituitary tumor patients.

On arrival in the operating room, standard monitoring devices, including electrocardiogram, pulse oximetry, noninvasive blood pressure cuff, and bispectral index (BIS) will be applied to the patients. Propofol with the modified Marsh pharmacokinetic parameters using a keo of 1.2/min will be administered through TCI pump (OrchestraBase Primea, Fresenius Vial, France). The initial target Ce of propofol will be chosen as 3.0 mg/mL (0.5 mg/mL of incremental size) based on an earlier study.

The sedation of patients will be assessed with BIS score and the modified observer's assessment of awareness and sedation (OAA/S). LOC was defined as an OAA/S lower than 2 (loss of response to spoken command to eye opening and loss of response to mild prodding or shaking). The primary end point of this study is the Ce of propofol when the BIS score is 40. The secondary end point of this study is the Ce of propofol at LOC.

Recruitment & Eligibility

Inclusion Criteria

patients with pituitary somatotroph tumor and with nonfunctioning pituitary tumor in transsphenoidal pituitary surgery
American society of anesthesiologists classification 1 or 2

Exclusion Criteria

left ventricle ejection fraction < 55% 3RD degree AV block, 2nd degree AV block with P:QRS > 3:1
serum Creatinine > 1.0mg/dl
myocardial infarction or cerebral stroke in 1 yrs
fever > 38C
dementia, cognitive disorder, confused mental status
pregnant patients
allergic to propofol
illiteracy or foreigners

Arm && Interventions

Group	Intervention	Description
patients with nonfunctioning pituitary tumor	Not applicable (measuring subject's effect site concentration of propofol during the induction of general anesthesia)	patients with nonfunctioning pituitary tumor undergoing transsphenoidal pituitary surgery under total intravenous anesthesia
patients with pituitary somatotroph tumor	Not applicable (measuring subject's effect site concentration of propofol during the induction of general anesthesia)	patients with pituitary somatotroph tumor undergoing transsphenoidal pituitary surgery under total intravenous anesthesia

Primary Outcome Measures

Name	Time	Method
effect site concentration of propofol	5 minutes after subject's anesthesia induction	Investigators will assess the propofol requirement in pituitary tumor patients during the induction of general anesthesia when subject's BIS (Bispectral Index Score) is 40

Secondary Outcome Measures

Name	Time	Method
effect site concentration of propofol	2 minutes after subject's anesthesia induction	Investigators will assess the propofol requirement in pituitary tumor patients during the induction of general anesthesia when the pituitary tumor patients lose their consciousness.

Locations (1): Associate Professor Department of Anesthesiology and Pain Medicine
🇰🇷
Seoul, Korea, Republic of

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