Comparison of Propofol Requirement Between Patients With Pituitary Somatotroph Tumor and With Nonfunctioning Pituitary Tumor in Transsphenoidal Pituitary Surgery Under Total Intravenous Anesthesia
Comparison of Propofol Requirement Between Patients With Pituitary Somatotroph Tumor and With Nonfunctioning Pituitary Tumor in Transsphenoidal Pituitary Surgery Under Total Intravenous Anesthesia
Investigators hypothesized that propofol dose for pituitary somatotroph patients might differ
 from nonfunctioning pituitary tumor, and investigators will evaluate a target controlled
 infusion (TCI) effect site concentration (Ce) of propofol for BIS score of 40 and LOC (loss
 of consciousness) in pituitary somatotroph patients in comparison with non functioning
 pituitary tumor patients.

 On arrival in the operating room, standard monitoring devices, including electrocardiogram,
 pulse oximetry, noninvasive blood pressure cuff, and bispectral index (BIS) will be applied
 to the patients. Propofol with the modified Marsh pharmacokinetic parameters using a keo of
 1.2/min will be administered through TCI pump (OrchestraBase Primea, Fresenius Vial, France).
 The initial target Ce of propofol will be chosen as 3.0 mg/mL (0.5 mg/mL of incremental size)
 based on an earlier study.

 The sedation of patients will be assessed with BIS score and the modified observer's
 assessment of awareness and sedation (OAA/S). LOC was defined as an OAA/S lower than 2 (loss
 of response to spoken command to eye opening and loss of response to mild prodding or
 shaking). The primary end point of this study is the Ce of propofol when the BIS score is 40.
 The secondary end point of this study is the Ce of propofol at LOC.
Inclusion Criteria:

 -  patients with pituitary somatotroph tumor and with nonfunctioning pituitary tumor in
 transsphenoidal pituitary surgery

 -  American society of anesthesiologists classification 1 or 2

 Exclusion Criteria:

 -  left ventricle ejection fraction < 55% 3RD degree AV block, 2nd degree AV block with
 P:QRS > 3:1

 -  serum Creatinine > 1.0mg/dl

 -  myocardial infarction or cerebral stroke in 1 yrs

 -  fever > 38C

 -  dementia, cognitive disorder, confused mental status

 -  pregnant patients

 -  allergic to propofol

 -  illiteracy or foreigners