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- Title
Effects of anesthetics on post-operative 3-month neuroendocrine function after endoscopic transsphenoidal non-functional pituitary adenoma surgery.
- Authors
Oh, Hyongmin; Yhim, Hyung‐Been; Yoon, Hyun‐Kyu; Lee, Hyung‐Chul; Hee Kim, Jung; Hwy Kim, Yong; Park, Hee‐Pyoung; Yhim, Hyung-Been; Yoon, Hyun-Kyu; Lee, Hyung-Chul; Park, Hee-Pyoung
- Abstract
<bold>Background: </bold>Anesthetic techniques can affect perioperative neuroendocrine function. The objective of this study was to compare 3-month post-operative neuroendocrine functional outcomes between sevoflurane and propofol anesthesia in patients undergoing endoscopic transsphenoidal surgery (ETS) for removal of non-functional pituitary adenomas (NFPAs) retrospectively.<bold>Methods: </bold>Among 356 patients who underwent ETS for removal of NFPAs under sevoflurane-remifentanil anesthesia (sevoflurane group, n = 103) or propofol-remifentanil anesthesia (propofol group, n = 253), 92 patients in each group were selected and their 3-month post-operative neuroendocrine functional outcomes (primary outcome measure) were compared after propensity score matching.<bold>Results: </bold>Overall changes in post-operative 3-month neuroendocrine function compared to pre-operative baseline did not differ between the sevoflurane and propofol groups (worsened: 32.6% vs 29.3%, persistently decreased: 9.8% vs 12.0%, improved: 12.0% vs 20.7%, normalized: 9.8% vs 12.0%, persistently normal: 18.5% vs 19.6%; P = .400). The incidence of pituitary hormone deficiency at 3 months post-operatively did not differ between the sevoflurane and propofol groups (adrenocorticotropic hormone deficiency: 18.5% vs 17.4%, P = 1.000; thyroid-stimulating hormone deficiency: 10.9% vs 3.3%, P = .081; gonadotropin deficiency: 54.3% vs 48.9%, P = .555; growth hormone deficiency: 45.7% vs 48.9%, P = .768; panhypopituitarism: 1.1% vs 1.1%, P = 1.000).<bold>Conclusion: </bold>In patients undergoing ETS for removal of NFPAs, the effects of both sevoflurane-remifentanil and propofol-remifentanil anesthetic techniques on post-operative 3-month neuroendocrine functional outcomes were similar, suggesting that propofol and sevoflurane can be freely used in such patients in terms of post-operative intermediate-term neuroendocrine functional outcome.
- Subjects
PITUITARY dwarfism; HORMONE deficiencies; INTRAVENOUS anesthesia; ANESTHETICS; PROPENSITY score matching; ADRENOCORTICOTROPIC hormone; PITUITARY surgery; PREVENTION of surgical complications; PROPOFOL; INHALATION anesthetics; NEUROENDOCRINE system; ADENOMA; RETROSPECTIVE studies; INTRAVENOUS anesthetics; PITUITARY tumors; ENDOSCOPY; LONGITUDINAL method
- Publication
Acta Anaesthesiologica Scandinavica, 2020, Vol 64, Issue 8, p1063
- ISSN
0001-5172
- Publication type
journal article
- DOI
10.1111/aas.13646