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Clinical comparison of remifentanil–sevoflurane vs. remifentanil–propofol for endoscopic endonasal transphenoidal surgery

Published online by Cambridge University Press:  01 May 2007

T. Cafiero ,
L. M. Cavallo ,
A. Frangiosa ,
R. Burrelli ,
G. Gargiulo ,
P. Cappabianca  and
E. de Divitiis
T. Cafiero*
Affiliation:
Cardarelli Hospital, Department of Anesthesiology and Postoperative Intensive Care, Naples, Italy
L. M. Cavallo
Affiliation:
Università degli Studi di Napoli Federico II, Department of Neurosurgery, Naples, Italy
A. Frangiosa
Affiliation:
Università degli Studi di Napoli Federico II, Department of Anesthesiology, Naples, Italy
R. Burrelli
Affiliation:
Università degli Studi di Napoli Federico II, Department of Anesthesiology, Naples, Italy
G. Gargiulo
Affiliation:
Università degli Studi di Napoli Federico II, Department of Anesthesiology, Naples, Italy
P. Cappabianca
Affiliation:
Università degli Studi di Napoli Federico II, Department of Neurosurgery, Naples, Italy
E. de Divitiis
Affiliation:
Università degli Studi di Napoli Federico II, Department of Neurosurgery, Naples, Italy
*
Correspondence to: Tullio Cafiero, Department of Anesthesiology and Postoperative Intensive Care, Cardarelli Hospital, Via B. Cavallino, 145, 80131 Napoli, Italy. E-mail: tcafiero@tiscali.it; Tel/Fax: +390815456294
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Summary

Background

Endoscopic endonasal transphenoidal surgery has been recently proposed as a minimally invasive procedure for the treatment of pituitary adenomas. The main objective of the anaesthesiologist is to induce sufficient haemodynamic control together with rapid recovery at the end of surgery. The aim of this study was to examine recovery profile, surgical operative conditions and haemodynamic differences using remifentanil infusion with either propofol target controlled infusion system or sevoflurane.

Method

Forty-four adult patients were enrolled in a prospective, randomized, single-blind, two-group study: Group P received propofol target controlled infusion system and remifentanil; Group S received sevoflurane and remifentanil for maintenance of anaesthesia.

Results

No statistically significant differences between the two groups with regards to the haemodynamic changes, operative conditions as assessed by a four-step bleeding score (0–3), were obtained. Recovery times were considerably shorter after remifentanil–sevoflurane in comparison with remifentanil–propofol target controlled infusion system group (7.4 vs. 12.8 min, P < 0.01).

Conclusion

This study demonstrates that sevoflurane–remifentanil gives a faster recovery and equivalent intraoperative status compared with propofol target controlled infusion system with remifentanil for the endoscopic endonasal transphenoidal approach.

Keywords

ANAESTHESIA INHALATIONALANAESTHETIC AGENTS, sevofluraneANAESTHESIA INTRAVENOUSPROPOFOLANALGESICS OPIOID, remifentanilSURGERY, pituitary, endoscopic, transphenoidal
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 5 , May 2007 , pp. 441 - 446
Copyright
Copyright © European Society of Anaesthesiology 2007

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Footnotes

This paper has been presented in part at the 13th World Congress of Anesthesiologists, Paris, April 18–23 2004.

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