Target-Controlled Infusion (TCI) vs Inhalational Anesthesia in Video-Assisted Thoracoscopic Surgery (VATS) (TCI-INHALE)

Prospective Observational Cohort Study Comparing Recovery Profiles After Target-Controlled Infusion Versus Inhalational Anesthesia in Video-Assisted Thoracoscopic Surgery

This study is designed as a prospective observational cohort to evaluate recovery after video-assisted thoracoscopic surgery (VATS). In our clinic, anesthesia for VATS is commonly provided either with target-controlled infusion (TCI) or with inhalational agents, depending on the routine practice of the anesthesiologist. No randomization or additional intervention will be performed.

During the study period, patients who receive either method as part of standard care will be followed, and perioperative and postoperative data will be recorded. Awakening time, extubation time, Aldrete score progression, pain levels, and early postoperative complications will be compared between the two groups. The aim is to better understand how these widely used anesthesia techniques may influence recovery in VATS patients and to support future clinical decision-making.

Study Overview

• Status: Recruiting
• Conditions: General Anesthesia; Video-assisted Thoracoscopic Surgery (VATS); Postoperative Recovery; Thoracic Surgery, Video Assisted; Anesthesia Techniques

Detailed Description

This study is planned as a prospective observational cohort carried out in patients undergoing video-assisted thoracoscopic surgery (VATS). In routine practice at our institution, anesthesia for these operations is provided either with target-controlled infusion (TCI)-based total intravenous anesthesia or with inhalational agents. The study will not change the type of anesthesia given to any patient. The method used will depend entirely on the attending anesthesiologist's usual clinical choice.

Patients receiving either technique during the study period will be followed, and perioperative variables will be documented. These include basic demographic data, intraoperative hemodynamic changes, duration of anesthesia, administered drug doses, and oxygenation parameters. Postoperative recovery will be assessed mainly through awakening and extubation times, Aldrete scores, sedation assessments, pain scores, and early complications such as nausea and vomiting.

The purpose of this observational design is to compare the two commonly used anesthesia approaches as they are applied in real clinical practice. By examining postoperative recovery patterns and any differences between groups, the study aims to provide practical information that may help guide anesthesia selection in VATS procedures. No additional risk or intervention will be introduced, and all patient data will be collected in accordance with routine clinical monitoring.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: mert katılmış, md; Phone Number: +905346430560; Email: mertkatilmis97@gmail.com

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye)
      • Recruiting
      • Istanbul University Cerrahpasa Medical Faculty
      • Contact: mert katılmış, medical doctor; Phone Number: +905346430560; Email: mertkatilmis97@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adult patients undergoing elective video-assisted thoracoscopic surgery (VATS) at our institution. In routine practice, anesthesia for these procedures is provided either with target-controlled infusion (TCI) or with inhalational agents, according to the preference of the attending anesthesiologist. Patients between 18 and 65 years of age who meet the clinical criteria for VATS and are able to give informed consent will be included. Individuals with significant cardiorespiratory instability, ASA IV or higher, or conditions that may interfere with postoperative assessment will not be enrolled.

Description

Inclusion Criteria:

• Adults aged 18 to 65 years

Patients scheduled for elective video-assisted thoracoscopic surgery (VATS)

ASA physical status I-III

Able to provide informed consent

Planned postoperative recovery in PACU and surgical ward

Exclusion Criteria:

• ASA IV or higher

Hemodynamic or respiratory instability before surgery

Known allergy or contraindication to commonly used anesthetic agents

Neurological or psychiatric conditions that may interfere with recovery assessment

Emergency surgeries

Patients who decline participation

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
TCI Group; Patients receiving target-controlled infusion (TCI) anesthesia as part of routine clinical care during VATS procedures. No intervention is assigned by the study team.
Inhalational Anesthesia Group; Patients receiving inhalational anesthesia (e.g., sevoflurane) as part of routine clinical care during VATS procedures. No intervention is assigned by the study team.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Extubation Time	Time from discontinuation of anesthesia to removal of the endotracheal tube. Extubation time will be recorded routinely in the operating room as part of standard postoperative monitoring.	Up to 30 minutes after the end of surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Awakening Time	Time from the end of anesthesia to the patient's first response to verbal command (eye opening or hand squeeze), recorded routinely in the operating room.	Up to 20 minutes after surgery
Aldrete Score Progression	Aldrete scores will be recorded at standard intervals in the post-anesthesia care unit (PACU) to evaluate early recovery. The time needed to reach an Aldrete score of 9 will be compared between groups.	PACU stay, up to 1 hour
Postoperative Pain Score (NRS)	Numeric Rating Scale (0-10) will be used to assess postoperative pain at PACU admission and during the early postoperative period.	First hour after PACU admission

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa

Study record dates

Study Major Dates

• Study Start (Actual): January 12, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: December 4, 2025
• First Submitted That Met QC Criteria: December 4, 2025
• First Posted (Actual): December 17, 2025

Study Record Updates

• Last Update Posted (Actual): March 24, 2026
• Last Update Submitted That Met QC Criteria: March 23, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Thoracic Surgery; VATS; Inhalational Anesthesia; Postoperative Recovery; Video-Assisted Thoracoscopic Surgery; Target-Controlled Infusion; Extubation Time
• Other Study ID Numbers: E-24687260-604.01-1455240

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because the study involves routinely collected clinical information, and the dataset contains sensitive patient details that cannot be made publicly available. All data will be used only within the study team and stored according to institutional privacy policies.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No