Type of anesthesia and quality of recovery in male patients undergoing lumbar surgery: a randomized trial comparing propofol-remifentanil total i.v. anesthesia with sevoflurane anesthesia

Wenjun Meng, Chengwei Yang, Xin Wei, Sheng Wang, Fang Kang, Xiang Huang, Juan Li, Wenjun Meng, Chengwei Yang, Xin Wei, Sheng Wang, Fang Kang, Xiang Huang, Juan Li

Abstract

Background: Previous studies have shown that women achieve a better quality of postoperative recovery from total intravenous anesthesia (TIVA) than from inhalation anesthesia, but the effect of anesthesia type on recovery in male patients is unclear. This study therefore compared patient recovery between males undergoing lumbar surgery who received TIVA and those who received sevoflurane anesthesia.

Methods: Eighty male patients undergoing elective one- or two-level primary transforaminal lumbar interbody fusion (TLIF) were randomly divided into two groups: the TIVA group (maintenance was achieved with propofol and remifentanil) or sevoflurane group (SEVO group: maintenance was achieved with sevoflurane and remifentanil). The quality of recovery-40 questionnaire (QoR-40) was administered before surgery and on postoperative days 1 and 2 (POD1 and POD2). Pain scores, postoperative nausea and vomiting, postoperative hospital stay, anesthesia consumption, and adverse effects were recorded.

Results: The QoR-40 scores were similar on the three points (Preoperative, POD1 and POD2). Pain scores were significantly lower in the SEVO group than in the TIVA group on POD1 (30.6 vs 31.4; P = 0.01) and POD2 (32 vs 33; P = 0.002). There was no significant difference in the postoperative hospital stay or complications in the postanesthesia care unit between the TIVA group and the SEVO group.

Conclusions: This study demonstrates that the quality of recovery is not significantly different between male TLIF surgery patients who receive TIVA and those who receive sevoflurane anesthesia. Patients in the TIVA group had better postoperative analgesic effect on POD2.

Trial registration: This was registered at http://www.chictr.org.cn (registration number ChiCTR-IOR-16007987, registration date: 24/02/2016).

Keywords: Anesthesia; General; Propofol; Recovery; Sevoflurane.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
A flowchart that outlines patient selection, randomization,and analysis
Fig. 2
Fig. 2
Perioperative MAP comparisons between the TIVA and SEVO groups. MAP, mean arterial pressure; T0, preoperative; T1, 10 min after induction; T2, cessation of main anesthetics; T3, tracheal extubation; T4, admission to PACU; T5, discharge from PACU
Fig. 3
Fig. 3
Perioperative HR comparisons between the TIVA and SEVO groups. HR, heart rate; T0, preoperative; T1, 10 min after induction T2, cessation of main anesthetics; T3, tracheal extubation; T4, admission to PACU; T5, discharge from PACU

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