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Quality of recovery in patients undergoing endoscopic sinus surgery after general anesthesia: total intravenous anesthesia vs desflurane anesthesia
Author(s) -
Liu Tingjie,
Gu Yurong,
Chen Kaizheng,
Shen Xia
Publication year - 2019
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22246
Subject(s) - medicine , desflurane , anesthesia , remifentanil , propofol , postoperative nausea and vomiting , randomized controlled trial , sevoflurane , surgery , vomiting
Background For sinus surgery, some centers favor total intravenous anesthesia (TIVA) over inhalation anesthesia. However, whether TIVA affects the patient's perceived quality of recovery remains unclear. This study used the Quality of Recovery–40 questionnaire (QoR‐40) to compare patient recovery between surgical patients who received TIVA and those who received desflurane (DES) anesthesia. Methods Eighty patients (20 to 65 years old) undergoing endoscopic sinus surgery were prospectively enrolled and randomized to either the TIVA (propofol and remifentanil infusion) or DES (desflurane inhalation and remifentanil infusion) group. The QoR‐40 was administered before surgery, at 6 hours after surgery, and on postoperative day 1 (POD1). Incidence of nausea and vomiting, remifentanil consumption, blood loss, and pain treatment were recorded. The influence of lesion extent (indexed as Lund‐Mackay [LM] score) on recovery quality was also assessed. Results Forty patients were randomized into the TIVA group, and 40 patients were randomized into the DES group. The QoR‐40 score at 6 hours after surgery was significantly higher in the TIVA group compared with the DES group (188.2 vs 182.6, respectively; p = 0.049), indicating a better quality of recovery in the TIVA group. TIVA resulted in less blood loss ( p < 0.0001). A high LM score (≥12) was associated with lower QoR‐40 scores at 6 hours after surgery (180.2 vs 187.2, p = 0.028) and on POD1 (181.5 vs 190.3, p = 0.003). Conclusion This study shows that the quality of recovery for endoscopic sinus surgery patients was better with TIVA than with desflurane anesthesia. A high LM score was related to poorer recovery quality.