Anesthesia choice makes no difference for patient recovery after major surgery, landmark UK trial finds
Choice of general anesthetic for major surgery can continue to be based on patient and clinician preference, according to the largest-ever trial comparing the two main techniques used in the NHS.
A major UK trial has found that the choice of anesthesia during major surgery does not affect patient recovery. The VITAL trial, led by the University of Warwick and The Royal Marsden NHS Foundation Trust, compared total intravenous anesthesia (TIVA) using propofol to traditional volatile anesthetic gases, delivering similar results across various measures.
Both approaches are commonly used for over 1.5 million major noncardiac operations annually in the U.K. The trial, involving 2,507 patients aged 50 and older across 49 NHS hospitals, found no meaningful difference in the number of days patients were hospitalized 30 days post-surgery, major complications, delirium, or death within 30, 90 days, and 6 months.
However, TIVA recipients reported lower rates of early postoperative discomfort like thirst, hoarseness, nausea, and vomiting. The findings, published in the Journal of the American Medical Association and Anaesthesia, suggest that clinicians should continue to choose the best-suited technique based on patient preference, clinical expertise, and local availability, rather than mandating a single approach.
Researchers note limitations, including the trial not being blinded, participants being NHS-only, and not examining longer-term outcomes or environmental impacts of different techniques.
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