Volatile vs Total intravenous Anaesthesia for major non-cardiac surgery: a pragmatic randomised triaL (VITAL)

Trials. 2024 Jun 27;25(1):414. doi: 10.1186/s13063-024-08159-w.

Abstract

Background: Improving outcomes after surgery is a major public health research priority for patients, clinicians and the NHS. The greatest burden of perioperative complications, mortality and healthcare costs lies amongst the population of patients aged over 50 years who undergo major non-cardiac surgery. The Volatile vs Total Intravenous Anaesthesia for major non-cardiac surgery (VITAL) trial specifically examines the effect of anaesthetic technique on key patient outcomes: quality of recovery after surgery (quality of recovery after anaesthesia, patient satisfaction and major post-operative complications), survival and patient safety.

Methods: A multi-centre pragmatic efficient randomised trial with health economic evaluation comparing total intravenous anaesthesia with volatile-based anaesthesia in adults (aged 50 and over) undergoing elective major non-cardiac surgery under general anaesthesia.

Discussion: Given the very large number of patients exposed to general anaesthesia every year, even small differences in outcome between the two techniques could result in substantial excess harm. Results from the VITAL trial will ensure patients can benefit from the very safest anaesthesia care, promoting an early return home, reducing healthcare costs and maximising the health benefits of surgical treatments.

Trial registration: ISRCTN62903453. September 09, 2021.

Keywords: General anaesthesia; Major surgery; Patient outcomes; Post-operative complications; Randomised controlled trial.

Publication types

  • Clinical Trial Protocol
  • Comparative Study

MeSH terms

  • Aged
  • Anesthesia Recovery Period
  • Anesthesia, General / adverse effects
  • Anesthesia, General / economics
  • Anesthesia, General / methods
  • Anesthesia, Inhalation / adverse effects
  • Anesthesia, Inhalation / economics
  • Anesthesia, Inhalation / methods
  • Anesthesia, Intravenous* / adverse effects
  • Anesthesia, Intravenous* / economics
  • Anesthesia, Intravenous* / methods
  • Elective Surgical Procedures
  • Female
  • Health Care Costs
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Patient Satisfaction*
  • Postoperative Complications* / economics
  • Postoperative Complications* / etiology
  • Postoperative Complications* / prevention & control
  • Pragmatic Clinical Trials as Topic
  • Treatment Outcome