Quality of recovery in patients undergoing endoscopic sinus surgery after general anesthesia: total intravenous anesthesia vs desflurane anesthesia.
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.
['Liu|Tingjie|T|', 'Gu|Yurong|Y|', 'Chen|Kaizheng|K|', 'Shen|Xia|X|']
D000328:Adult D000368:Aged D000762:Anesthesia Recovery Period D000768:Anesthesia, General D000771:Anesthesia, Intravenous D000077335:Desflurane D004724:Endoscopy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010256:Paranasal Sinuses D015742:Propofol D058996:Quality Improvement D000077208:Remifentanil D016896:Treatment Outcome D055815:Young Adult
recovery desflurane propofol postoperative IV anesthetic anesthetics volatile