Effects of anesthetics on post‐operative 3‐month neuroendocrine function after endoscopic transsphenoidal non‐functional pituitary adenoma surgery

Background Anesthetic techniques can affect perioperative neuroendocrine function. The objective of this study was to compare 3‐month post‐operative neuroendocrine functional outcomes between sevoflurane and propofol anesthesia in patients undergoing endoscopic transsphenoidal surgery (ETS) for removal of non‐functional pituitary adenomas (NFPAs) retrospectively. Methods Among 356 patients who underwent ETS for removal of NFPAs under sevoflurane‐remifentanil anesthesia (sevoflurane group, n = 103) or propofol‐remifentanil anesthesia (propofol group, n = 253), 92 patients in each group were selected and their 3‐month post‐operative neuroendocrine functional outcomes (primary outcome measure) were compared after propensity score matching. Results Overall changes in post‐operative 3‐month neuroendocrine function compared to pre‐operative baseline did not differ between the sevoflurane and propofol groups (worsened: 32.6% vs 29.3%, persistently decreased: 9.8% vs 12.0%, improved: 12.0% vs 20.7%, normalized: 9.8% vs 12.0%, persistently normal: 18.5% vs 19.6%; P = .400). The incidence of pituitary hormone deficiency at 3 months post‐operatively did not differ between the sevoflurane and propofol groups (adrenocorticotropic hormone deficiency: 18.5% vs 17.4%, P = 1.000; thyroid‐stimulating hormone deficiency: 10.9% vs 3.3%, P = .081; gonadotropin deficiency: 54.3% vs 48.9%, P = .555; growth hormone deficiency: 45.7% vs 48.9%, P = .768; panhypopituitarism: 1.1% vs 1.1%, P = 1.000). Conclusion In patients undergoing ETS for removal of NFPAs, the effects of both sevoflurane‐remifentanil and propofol‐remifentanil anesthetic techniques on post‐operative 3‐month neuroendocrine functional outcomes were similar, suggesting that propofol and sevoflurane can be freely used in such patients in terms of post‐operative intermediate‐term neuroendocrine functional outcome.