• Eur J Anaesthesiol · May 2007

    Randomized Controlled Trial Comparative Study

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

    • T Cafiero, L M Cavallo, A Frangiosa, R Burrelli, G Gargiulo, P Cappabianca, and E de Divitiis.
    • Cardarelli Hospital, Department of Anesthesiology and Postoperative Intensive Care, Naples, Italy. tcafiero@tiscali.it
    • Eur J Anaesthesiol. 2007 May 1;24(5):441-6.

    BackgroundEndoscopic 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.MethodForty-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.ResultsNo 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).ConclusionThis 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.

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