Comparison of Total Intravenous Anesthesia (TIVA) versus Volatile Induction Maintenance Anesthesia (VIMA) Complemented by Controlled Hypotension on Quality of Surgical Field during Transsphenoidal Resection of Pituitary Tumor

Background: To compare quality of surgical field assessed by the surgeon using Boezaart’s score in patients receiving TIVA and VIMA complemented by controlled hypotension. Effect on the hemodynamic parameters, estimated blood loss, and recovery profile were recorded.

Materials and Methods: A prospective randomized controlled trial was conducted on 72 patients undergoing transsphenoidal resection of pituitary tumor after approval from Institute Ethics Committee and written informed consent from patients. TIVA group received propofol infusion and VIMA group received sevoflurane. Dexmedetomidine and lignocaine infusions were used for controlled hypotensive in both the groups. Primary objective was quality of surgical field assessed by the surgeon using Boezaart’s score. Secondary objectives were to observe effect on the hemodynamic parameters, estimated blood loss and recovery profile.

Results: Thirty-six patients were included in each group. Quality of surgical field was good and comparable in both the groups. Both the groups have shown quality of surgical field with a median score of 1 in 15 minutes and a median score of 2 in the rest of the intraoperative period. Emergence time and extubation time were statistically shorter in TIVA group with a p-value of 0.005 and 0.038, respectively.

Conclusions: There was no difference in quality of surgical field using anesthetic technique TIVA or VIMA during transsphenoidal resection of pituitary tumor although emergence was faster in patients receiving TIVA.

Publication History

Article published online:
25 March 2020