A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma
Abstract Background The effects of inhalation anesthesia as compared with total intravenous anesthesia (TIVA) on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma have not been well studied. Methods This randomized clinical trial enrolled patients u...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-025-03263-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849761386709647360 |
|---|---|
| author | Yunying Feng Yuelun Zhang Wei Lian Yang Xue Manjiao Ma Xuerong Yu Xiaopeng Guo Lulu Ma Bing Xing Yuguang Huang |
| author_facet | Yunying Feng Yuelun Zhang Wei Lian Yang Xue Manjiao Ma Xuerong Yu Xiaopeng Guo Lulu Ma Bing Xing Yuguang Huang |
| author_sort | Yunying Feng |
| collection | DOAJ |
| description | Abstract Background The effects of inhalation anesthesia as compared with total intravenous anesthesia (TIVA) on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma have not been well studied. Methods This randomized clinical trial enrolled patients undergoing transsphenoidal surgery between May 2023 to April 2024. Patients were randomly assigned in a 1:1 ratio to receive inhalation anesthesia or TIVA. The primary endpoint was the 15-item Quality of Recovery Scale (QoR-15) score on the first postoperative day. Secondary endpoints included postoperative anesthesia recovery patterns, neuroendocrine stress responses, cellular immune responses, and recovery quality. Subgroup analyses were also conducted for the postoperative QoR-15 scores and neuroendocrine stress responses. Potential influence factors for QoR-15 scores and changes in counts of lymphocytes were explored. Results A total of 252 patients were randomized. No significant difference in postoperative QoR-15 scores was observed between groups and the between-group difference was well below the minimal clinically important difference (median difference 1.0, 95% confidence interval [CI]– 4.0 to 5.0, P = 0.647). Compared with the inhalation group, the TIVA group exhibited significantly lower Richmond agitation-sedation scale (RASS) score and reduced antiemetic drug use in the postanesthesia care unit. Subgroup analyses for postoperative QoR-15 scores revealed no significant interactions. Adrenocorticotropic hormone levels on postoperative day 1 were lower in the inhalation group, while thyroxine and serum free thyroxine levels were higher. No significant differences in these neuroendocrine indices were found in postoperative month 3. Lymphocyte subset levels did not differ between groups on postoperative day 1, although perioperative changes in immune cell counts were correlated with patient demographic and clinical characteristics. Conclusion Both anesthesia methods resulted in comparable short-term postoperative recovery quality as measured by the QoR-15 scores. TIVA was associated with smoother anesthesia recovery and lower immediate antiemetic requirements. Differences in early neuroendocrine responses were observed but did not persist at 3 months postoperatively. Trial registration The trial is registered with the ClinicalTrials.gov platform (registration number: NCT05822817; date of registration: March 13, 2023). |
| format | Article |
| id | doaj-art-3f0bb28591fd4d27aa76b89d241bc73b |
| institution | DOAJ |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj-art-3f0bb28591fd4d27aa76b89d241bc73b2025-08-20T03:06:02ZengBMCBMC Anesthesiology1471-22532025-08-0125111110.1186/s12871-025-03263-zA randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenomaYunying Feng0Yuelun Zhang1Wei Lian2Yang Xue3Manjiao Ma4Xuerong Yu5Xiaopeng Guo6Lulu Ma7Bing Xing8Yuguang Huang9Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeInstitute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background The effects of inhalation anesthesia as compared with total intravenous anesthesia (TIVA) on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma have not been well studied. Methods This randomized clinical trial enrolled patients undergoing transsphenoidal surgery between May 2023 to April 2024. Patients were randomly assigned in a 1:1 ratio to receive inhalation anesthesia or TIVA. The primary endpoint was the 15-item Quality of Recovery Scale (QoR-15) score on the first postoperative day. Secondary endpoints included postoperative anesthesia recovery patterns, neuroendocrine stress responses, cellular immune responses, and recovery quality. Subgroup analyses were also conducted for the postoperative QoR-15 scores and neuroendocrine stress responses. Potential influence factors for QoR-15 scores and changes in counts of lymphocytes were explored. Results A total of 252 patients were randomized. No significant difference in postoperative QoR-15 scores was observed between groups and the between-group difference was well below the minimal clinically important difference (median difference 1.0, 95% confidence interval [CI]– 4.0 to 5.0, P = 0.647). Compared with the inhalation group, the TIVA group exhibited significantly lower Richmond agitation-sedation scale (RASS) score and reduced antiemetic drug use in the postanesthesia care unit. Subgroup analyses for postoperative QoR-15 scores revealed no significant interactions. Adrenocorticotropic hormone levels on postoperative day 1 were lower in the inhalation group, while thyroxine and serum free thyroxine levels were higher. No significant differences in these neuroendocrine indices were found in postoperative month 3. Lymphocyte subset levels did not differ between groups on postoperative day 1, although perioperative changes in immune cell counts were correlated with patient demographic and clinical characteristics. Conclusion Both anesthesia methods resulted in comparable short-term postoperative recovery quality as measured by the QoR-15 scores. TIVA was associated with smoother anesthesia recovery and lower immediate antiemetic requirements. Differences in early neuroendocrine responses were observed but did not persist at 3 months postoperatively. Trial registration The trial is registered with the ClinicalTrials.gov platform (registration number: NCT05822817; date of registration: March 13, 2023).https://doi.org/10.1186/s12871-025-03263-zInhalation anesthesiaTotal intravenous anesthesiaPituitary adenomaPostoperative recovery quality |
| spellingShingle | Yunying Feng Yuelun Zhang Wei Lian Yang Xue Manjiao Ma Xuerong Yu Xiaopeng Guo Lulu Ma Bing Xing Yuguang Huang A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma BMC Anesthesiology Inhalation anesthesia Total intravenous anesthesia Pituitary adenoma Postoperative recovery quality |
| title | A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma |
| title_full | A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma |
| title_fullStr | A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma |
| title_full_unstemmed | A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma |
| title_short | A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma |
| title_sort | randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma |
| topic | Inhalation anesthesia Total intravenous anesthesia Pituitary adenoma Postoperative recovery quality |
| url | https://doi.org/10.1186/s12871-025-03263-z |
| work_keys_str_mv | AT yunyingfeng arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yuelunzhang arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT weilian arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yangxue arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT manjiaoma arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT xuerongyu arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT xiaopengguo arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT luluma arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT bingxing arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yuguanghuang arandomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yunyingfeng randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yuelunzhang randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT weilian randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yangxue randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT manjiaoma randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT xuerongyu randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT xiaopengguo randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT luluma randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT bingxing randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma AT yuguanghuang randomizedcontrolledtrialtocomparetheeffectsofsevofluraneandpropofolformaintenanceofanesthesiaonpostoperativerecoveryqualityinpatientsundergoingtranssphenoidalresectionofpituitaryadenoma |