Comparison of postoperative outcomes after cranial neurosurgery using propofol-based total intravenous anesthesia versus inhalation anesthesia: a nationwide cohort study in South Korea.

Autor: Oh TK; Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea., Song IA; Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea., Jeon YT; Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Jazyk: angličtina
Zdroj: Korean journal of anesthesiology [Korean J Anesthesiol] 2024 Dec; Vol. 77 (6), pp. 614-622. Date of Electronic Publication: 2024 Oct 14.
DOI: 10.4097/kja.24443
Abstrakt: Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia.
Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications.
Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group.
Conclusions: There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.
Databáze: MEDLINE
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