Warwick leads medical trial investigating impact of anaesthetic choice

A trial into the relevance of anaesthetic choice during major surgeries has been conducted by the University of Warwick and The Royal Marsden NHS Foundational Trust.

The University’s Clinical Trial Unit – associated with Warwick Medical School – coordinated the trial, which was funded by the National Institute for Health and Care Research’s (NIHR) Health Technology Assessment Programme.

Through the randomised allocation of different anaesthetics on patients, researchers found that both anaesthetic techniques are practically equivalent in their function for adults having major non-cardiac surgery. The two forms of anaesthetic explored in the scientific study were TIVA (‘Total Intravenous Anaesthesia’) and inhalation.

The VITAL (Volatile vs Total Intravenous Anaesthesia for major non-cardiac surgery) trial concluded that there was “no meaningful difference” in the recovery process for the different groups.

The experimental trial analysed over 2,500 patients and compared the two main anaesthesia techniques used by the NHS, across almost 50 hospitals in Britain.

This research paper is the first ever large-scale study in the UK to explore the differences in patients’ experiences of recovering from major surgeries based on their choice of anaesthetic.

Primarily, the study based their recovery measurements on the number of days which patients remained non-hospitalised for, following their surgeries.

What our trial shows is that, for most patients having major surgery, the two methods are equally viable

Professor Joyce Yeung, Chief Investigator of VITAL

The findings are supported by an economic review into the cost-effectiveness of both techniques, which found that both anaesthetics offered similar costs to the NHS, as well as similar qualities of life during recovery.

A key reason behind this study taking place is that many doctors believed TIVA delivers faster recovery and higher survival rates for cancer patients, based on the conclusions of some early research. However, these findings were perceived as quite inconclusive and unreliable, because they originated from small studies.

Professor Joyce Yeung – Chief Investigator of VITAL – believes that this trial puts debates surrounding anaesthetic effectiveness to rest, as she stated: “What our trial shows is that, for most patients having major surgery, the two methods are equally viable.”

Yeung described these results as “reassuring for patients, and it means doctors can keep making that decision based on what’s right for the person in front of them”.

However, there are limitations to the study, including the lack of longer-term outcome analysis and reliance on patients self-reporting their symptoms.