MedPath

Comparison of Postoperative Recovery of Sevoflurane and Propofol After Transsphenoidal Surgery

Phase 4
Completed
Conditions
Pituitary Adenoma
Interventions
Registration Number
NCT05822817
Lead Sponsor
Peking Union Medical College Hospital
Brief Summary

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.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
252
Inclusion Criteria
  1. Men or women, aged from 18 to 70
  2. American Society of Anesthesiologists (ASA) class I - III
  3. Patients scheduled for transsphenoidal surgery requiring general anesthesia managed with endotracheal intubation
Exclusion Criteria
  1. Patients allergic or contraindicated to sevoflurane, propofol, or other drugs used during surgery
  2. Severe pulmonary disease, saturation of peripheral oxygen (SpO2) < 90%
  3. Severe nervous system disease with consciousness disorder
  4. Patients scheduled for intensive care unit (ICU) after surgery
  5. Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
sevofluranesevofluraneAnesthesia is maintained with sevoflurane.
propofolpropofolAnesthesia is maintained with continuous infusion of propofol.
Primary Outcome Measures
NameTimeMethod
15-item quality of recovery score (QoR-15)24 hours after end of surgery

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.

Secondary Outcome Measures
NameTimeMethod
Time to awake from anesthesiaFrom stopping sevoflurane or propofol to awake, approximately 30 minutes

The time between discontinuing drugs and response to verbal command.

Time to extubationFrom stopping sevoflurane or propofol to recovery of spontaneous breathing and withdrawal of tracheal tube, approximately 30 minutes

The time between discontinuing drugs and withdrawal of tracheal tube.

Coughing and bucking during emergenceFrom stopping sevoflurane or propofol to complete awakening, approximately 30 minutes

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 to discharge from postanesthesia care unit (PACU)From admit into PACU to discharge from PACU, approximately 45 minutes

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.

Concentration of serum growth hormone (GH)24 hours after end of surgery

The investigators examine the serum level of GH in ng/mL.

Incidence of hypotension during anesthesiaFrom start of surgery to end of surgery, on an average of 2 hours

Hypotension is defined as decrease of mean arterial pressure (MAP) more than 20% of baseline.

Concentration of serum thyroid-stimulating hormone (TSH)24 hours after end of surgery

The investigators examine the serum level of TSH in uIU/mL.

Concentration of serum prolactin (PRL)24 hours after end of surgery

The investigators examine the serum level of PRL ng/mL.

Counts of peripheral blood lymphocyte24 hours after end of surgery
Agitation or sedation level during emergenceFrom stopping sevoflurane or propofol to complete awakening, approximately 30 minutes

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.

PACU antiemetic drug useFrom admit into PACU to discharge from PACU, approximately 45 minutes

The drug use due to postoperative nausea and vomiting in PACU.

PACU analgesic drug useFrom admit into PACU to discharge from PACU, approximately 45 minutes

The drug use due to postoperative pain in PACU.

Post operative nausea and vomiting score24 hours after end of surgery

Score: 0, no nausea and vomiting; 1-4, mild nausea and vomiting; 5-6, moderate nausea and vomiting; 7-10, severe nausea and vomiting.

Concentration of serum adrenocorticotropic hormone (ACTH)24 hours after end of surgery

The investigators examine the serum level of ACTH in pg/mL.

Concentration of serum cortisol24 hours after end of surgery

The investigators examine the serum level of cortisol in ug/dL.

Concentration of serum gonadotrophin24 hours after end of surgery

The investigators examine the serum level of gonadotrophin in IU/L.

Incidence of hypertension during anesthesiaFrom start of surgery to end of surgery, on an average of 2 hours

Hypertension is defined as increase of MAP more than 20% of baseline.

Time to discharge from hospitalFrom end of surgery to discharge from hospital, on an average of 2 days

The time between end of surgery and discharge from hospital.

Trial Locations

Locations (1)

Peking Union Medical College Hospital

🇨🇳

Beijing, Beijing, China

© Copyright 2025. All Rights Reserved by MedPath