Effect of intraoperative dexmedetomidine on early postoperative quality of recovery in patients undergoing endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: a randomized controlled trial

Abstract

Abstract Purpose Intraoperative dexmedetomidine administration attenuates surgical stress response and reduces postoperative pain, which are both essential for enhancing postoperative quality of recovery (QoR). This study aimed to determine whether intraoperative dexmedetomidine could improve early postoperative QoR in patients with nonfunctioning pituitary adenoma (NFPA) undergoing endoscopic transsphenoidal surgery (ETS). Methods Patients with NFPA who underwent ETS under total intravenous anesthesia using continuous infusion of propofol and remifentanil were randomly assigned to receive either intraoperative dexmedetomidine (dexmedetomidine group, n = 29) or normal saline (control group, n = 32). The QoR-15 questionnaire was used to evaluate the postoperative QoR. The primary outcome measure was the QoR-15 score on postoperative day 1. Perioperative serum cortisol levels, intraoperative serum interleukin-6 levels, and pain scores at 4, 24, and 48 h postoperatively were also evaluated. Results The QoR-15 score on postoperative day 1 did not differ between the dexmedetomidine and control groups (94.0 [79.0–112.0] vs. 92.5 [68.3–110.8], P = 0.606). Perioperative serum cortisol levels showed no significant time × group effect (P = 0.578). Intraoperative serum interleukin-6 level did not differ between the two groups (P = 0.974). Pain score was lower in the dexmedetomidine group at 4 h postoperatively (0.0 [0.0–0.0] vs. 1.0 [0.0–3.0], P = 0.003) than the control group. Conclusion Dexmedetomidine, as an anesthetic adjuvant, did not improve early postoperative QoR in patients with NFPA during ETS.