Effects of propofol, desflurane, and sevoflurane on respiratory functions following endoscopic endonasal transsphenoidal pituitary surgery: a prospective randomized study

Korean J Anesthesiol. 2019 Dec;72(6):583-591. doi: 10.4097/kja.19336. Epub 2019 Oct 11.

Abstract

Background: General anesthesia with intravenous or inhalation anesthetics reduces respiratory functions. We investigated the effects of propofol, desflurane, and sevoflurane on postoperative respiratory function tests.

Methods: This single-center randomized controlled study was performed in a university hospital from October 2015 to February 2017. Ninety patients scheduled for endoscopic endonasal transsphenoidal pituitary surgery were randomly categorized into either of these three groups: propofol (n = 30, the Group TIVA), desflurane (n = 30, the Group D) or sevoflurane (n = 30, the Group S). We analyzed the patients before, after, and 24 h following surgery, to identify the following parameters: forced expiratory volume in 1 second (FEV1) %, forced vital capacity (FVC) %, FEV1/FVC, and arterial blood gases (ABG). Furthermore, we also recorded the intraoperative dynamic lung compliance and airway resistance values.

Results: We did not find any significant differences in FEV1 values (primary outcome) among the groups (P = 0.336). There was a remarkable reduction in the FEV1 and FVC values in all groups postoperatively relative to the baseline (P < 0.001). The FVC, FEV1/FVC, ABG analysis, compliance, and airway resistance were similar among the groups. Intraoperative dynamic compliance values were lower at the 1st and 2nd hours than those immediately after intubation (P < 0.001).

Conclusions: We demonstrated that propofol, desflurane, and sevoflurane reduced FEV1 and FVC values postoperatively, without any significant differences among the drugs.

Keywords: Airway resistance; Desflurane; Lung compliance; Propofol; Respiratory function tests; Sevoflurane.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Airway Resistance / drug effects
  • Anesthesia, General / methods
  • Anesthetics, Inhalation / pharmacology
  • Anesthetics, Intravenous / pharmacology
  • Carbon Dioxide / blood
  • Desflurane / pharmacology*
  • Endoscopy / methods
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Lung Compliance / drug effects
  • Male
  • Middle Aged
  • Oxygen / blood
  • Partial Pressure
  • Pituitary Gland / surgery*
  • Postoperative Period
  • Propofol / pharmacology*
  • Respiratory Physiological Phenomena / drug effects*
  • Sevoflurane / pharmacology*
  • Single-Blind Method
  • Vital Capacity / drug effects
  • Young Adult

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Carbon Dioxide
  • Sevoflurane
  • Desflurane
  • Oxygen
  • Propofol