J Neurosurg Anesthesiol 2021 Mar 23. Epub 2021 Mar 23.
Departments of Anesthesiology and Critical Care Neurosurgery, AHEPA University Hospital, Aristotle University of Thessaloniki, School of Medicine, University Campus Department of Neurosurgery, Hippokratio General Hospital, Aristotle University of Thessaloniki, School of Medicine, Konstantinoupoleos, Thessaloniki, Greece Department of Anesthesiology and Critical Care, Sapienza University of Rome, Rome, Italy.
Transnasal transsphenoidal (TNTS) pituitary surgery is associated with short-lived but intense nociceptive stimuli which cause substantial hemodynamic perturbations that may increase blood loss and impair visualization of the surgical field. This systematic review aimed to critically appraise the clinical evidence for the efficacy and safety of various anesthetic techniques, other pharmacological modalities, and supplementary interventions by assessing intraoperative systemic hemodynamics, use of adjunct medications, quality of the surgical field, intraoperative blood loss, and recovery profiles in patients undergoing TNTS pituitary surgery. Relevant randomized clinical trials and observational studies were identified in a systematic literature search; 16 studies (13 randomized clinical trials, 3 observational studies) enrolling a total of 907 patients were identified for inclusion in this review. Read More