title: [Comparision of stress response severity during intravenous, inhalation and combined anesthesia (inhalation plus local) for pituitary transsphenoidal adenomectomy].
abstract: Transsphenoidal pituitary surgery is usually accompanied by severe hemodynamic stress response which is hardly treated with fentanyl. The main goal of the study is to compare anesthetic methods for endonasal endoscopic transsphenoidal pituitary adenomectomy and single out the most effective way of reducing or preventing the stress reaction. 65 patients underwent endonasal endoscopic transsphenoidal pituitary adenomectomy. In all the patients general an- esthesia was induced with propofol. Analgesia was provided by phetanyl boluses. The patients were divided into three groups. In the first group of patients TIVA with propofol-TCI was used. In the second group of patients anesthesia was maintained by N20 plus sevoflurane. The third group of patients received an additional bilateral endoscopic mucosal 2% lidocain 5 ml infiltration of the pterygopalatine nerve branches zone. Pipecuronium was used for neuromuscular blockade. The simultaneous HR, ABP and metabolism increase were qualified as stress response. In the first and second groups of patients the maximum stress response was recorded on the stage of mucosal coagulation and on the opening of the blades of bivalve nasal speculum. No major difference in stress response severity was noted in these groups. In the third group stress response was significantly lower. According of the results of the study bilateral endoscopic mucosal lidocaine infiltration of the pterygopalatine nerve branches zone for anesthetic management of endonasal endoscopic transsphenoidal pituitary adenomectomy can be recommended.
authors.forename: D A
authors.initials: DA
authors.lastname: Aver'ianov
authors.forename: V Iu
authors.initials: VIu
authors.lastname: Cherebillo
authors.forename: V I
authors.initials: VI
authors.lastname: Shatalov
authors.forename: A V
authors.initials: AV
authors.lastname: Shchegolev
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000772:Anesthesia, Local; D005260:Female; D006801:Humans; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D013312:Stress, Physiological