1. Effects of anesthetics on post-operative 3-month neuroendocrine function after endoscopic transsphenoidal non-functional pituitary adenoma surgery.
- Author
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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, and Park, Hee-Pyoung
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PITUITARY dwarfism , *HORMONE deficiencies , *INTRAVENOUS anesthesia , *ANESTHETICS , *PROPENSITY score matching , *ADRENOCORTICOTROPIC hormone , *PITUITARY surgery , *PROPOFOL , *INHALATION anesthetics , *NEUROENDOCRINE system , *ADENOMA , *RETROSPECTIVE studies , *INTRAVENOUS anesthetics , *PITUITARY tumors , *ENDOSCOPY , *LONGITUDINAL method ,PREVENTION of surgical complications - Abstract
Background: 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.Methods: 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.Results: 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).Conclusion: 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. [ABSTRACT FROM AUTHOR]- Published
- 2020
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