title: Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol-remifentanil total i.v. anaesthesia with desflurane anaesthesia.
abstract: BACKGROUND
  Two common general anaesthetic methods are total i.v. anaesthesia (TIVA) and inhalation anaesthesia, but it is unclear whether this affects the patient's perception of their quality of recovery. The Quality of Recovery-40 questionnaire (QoR-40) is a valid and reliable method to evaluate the extent of functional recovery after surgery with general anaesthesia. This study therefore compared patient recovery using the QoR-40 in surgical patients who received TIVA with those who received desflurane anaesthesia.
  
  
  METHODS
  Eighty females (20-65 years old) undergoing thyroid surgery were prospectively recruited and randomized to either the TIVA (effect-site target controlled infusion using propofol and remifentanil) or DES (desflurane inhalation with manual infusion of remifentanil) groups. The QoR-40 was administered by an investigator blind to group allocation before surgery, and postoperative days 1 and 2 (POD1 and POD2). Additional data including the incidence of nausea or vomiting, the consumption of antiemetic and analgesic agents in the post-anaesthesia care unit, and the duration of the hospital stay, were collected in all cases.
  
  
  RESULTS
  The QoR-40 score on POD1 was significantly higher in the TIVA group compared with the DES group (174 vs 161, respectively; P=0.004), indicating a better quality of recovery in the TIVA group. Among the five dimensions of the QoR-40, physical comfort and physical independence were significantly better on POD1 and POD2 in the TIVA group.
  
  
  CONCLUSIONS
  This study demonstrates that the quality of recovery for female thyroid surgery patients is significantly better with TIVA compared with desflurane anaesthesia.
  
  
  BACKGROUND
  www.clinicaltrials.org; ref.: NCT01760018.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine.
authors.forename: W-K
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine.
authors.forename: M-S
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: S-W
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine.
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine leejeongrim@gmail.com.
authors.forename: J-R
authors.initials: JR
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000077335:Desflurane; D004311:Double-Blind Method; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil; D011795:Surveys and Questionnaires
chemical_list: D010880:Piperidines; D000077335:Desflurane; D007530:Isoflurane; D000077208:Remifentanil; D015742:Propofol
keywords: anaesthetics i.v., propofol; anaesthetics volatile, desflurane; recovery, postoperative