Randomized controlled trial of the effect of general anesthetics on postoperative recovery after minimally invasive nephrectomy
BACKGROUND: General anesthetic techniques can affect postoperative recovery. We compared the effect of propofol-based total intravenous anesthesia (TIVA) and desflurane anesthesia on postoperative recovery.
METHODS: In this randomized trial, 150 patients undergoing robot-assisted or laparoscopic nephrectomy for renal cancer were randomly allocated to either the TIVA or desflurane anesthesia (DES) group. Postoperative recovery was evaluated using the Korean version of the Quality of Recovery-15 questionnaire (QoR-15K) at 24 h, 48 h, and 72 h postoperatively. A generalized estimating equation (GEE) was performed to analyze longitudinal QoR-15K data. Fentanyl consumption, pain severity, postoperative nausea and vomiting, and quality of life three weeks after discharge were also compared.
RESULTS: Data were analyzed for 70 patients in each group. The TIVA group showed significantly higher QoR-15K scores at 24 and 48 h postoperatively (24 h: DES, 96 [77, 109] vs. TIVA, 104 [82, 117], median difference 8 [95% CI: 1, 15], P = 0.029; 48 h: 110 [95, 128] vs. 125 [109, 130], median difference 8 [95% CI: 1, 15], P = 0.022), however not at 72 h (P = 0.400). The GEE revealed significant effects of group (adjusted mean difference 6.2, 95% CI: 0.39, 12.1, P = 0.037) and time (P < 0.001) on postoperative QoR-15K scores without group-time interaction (P = 0.051). However, there were no significant differences in other outcomes, except for fentanyl consumption, within the first 24 h postoperatively.
CONCLUSIONS: Propofol-based TIVA showed only a transient improvement in postoperative recovery than desflurane anesthesia, without significant differences in other outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Korean journal of anesthesiology - 77(2024), 1 vom: 01. Feb., Seite 95-105 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yoon, Hyun-Kyu [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 05.02.2024 Date Revised 05.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.4097/kja.23083 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357343603 |
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| 100 | 1 | |a Yoon, Hyun-Kyu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Randomized controlled trial of the effect of general anesthetics on postoperative recovery after minimally invasive nephrectomy |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: General anesthetic techniques can affect postoperative recovery. We compared the effect of propofol-based total intravenous anesthesia (TIVA) and desflurane anesthesia on postoperative recovery | ||
| 520 | |a METHODS: In this randomized trial, 150 patients undergoing robot-assisted or laparoscopic nephrectomy for renal cancer were randomly allocated to either the TIVA or desflurane anesthesia (DES) group. Postoperative recovery was evaluated using the Korean version of the Quality of Recovery-15 questionnaire (QoR-15K) at 24 h, 48 h, and 72 h postoperatively. A generalized estimating equation (GEE) was performed to analyze longitudinal QoR-15K data. Fentanyl consumption, pain severity, postoperative nausea and vomiting, and quality of life three weeks after discharge were also compared | ||
| 520 | |a RESULTS: Data were analyzed for 70 patients in each group. The TIVA group showed significantly higher QoR-15K scores at 24 and 48 h postoperatively (24 h: DES, 96 [77, 109] vs. TIVA, 104 [82, 117], median difference 8 [95% CI: 1, 15], P = 0.029; 48 h: 110 [95, 128] vs. 125 [109, 130], median difference 8 [95% CI: 1, 15], P = 0.022), however not at 72 h (P = 0.400). The GEE revealed significant effects of group (adjusted mean difference 6.2, 95% CI: 0.39, 12.1, P = 0.037) and time (P < 0.001) on postoperative QoR-15K scores without group-time interaction (P = 0.051). However, there were no significant differences in other outcomes, except for fentanyl consumption, within the first 24 h postoperatively | ||
| 520 | |a CONCLUSIONS: Propofol-based TIVA showed only a transient improvement in postoperative recovery than desflurane anesthesia, without significant differences in other outcomes | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Enhanced recovery after surgery | |
| 650 | 4 | |a General anesthetics | |
| 650 | 4 | |a Inhalation anesthesia | |
| 650 | 4 | |a Intravenous anesthesia | |
| 650 | 4 | |a Perioperative medicine | |
| 650 | 4 | |a Postoperative period | |
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| 650 | 7 | |a YI7VU623SF |2 NLM | |
| 650 | 7 | |a Anesthetics, Intravenous |2 NLM | |
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| 650 | 7 | |a Anesthetics, Inhalation |2 NLM | |
| 700 | 1 | |a Joo, Somin |e verfasserin |4 aut | |
| 700 | 1 | |a Yoon, Susie |e verfasserin |4 aut | |
| 700 | 1 | |a Seo, Jeong-Hwa |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Won Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Ho-Jin |e verfasserin |4 aut | |
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