Authors: Cha YM et al.
Source: The Daily Dose — Friday, May 8, 2026
Coverage from the 2026 Annual Meeting presented by the International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA)
At the 2026 IARS/SOCCA Annual Meeting late-breaking perioperative medicine session, Joyce Yeung presented the VITAL trial (Volatile vs Total Intravenous Anaesthesia for Major Non-Cardiac Surgery), an important pragmatic randomized trial evaluating whether anesthetic technique influences recovery and outcomes after major noncardiac surgery.
The study compared volatile inhalational anesthesia with total intravenous anesthesia (TIVA) in adults aged 50 years and older undergoing elective major noncardiac surgery across the United Kingdom. Investigators utilized data from the Perioperative Quality Improvement Programme (PQIP) registry to assess clinically meaningful postoperative outcomes.
One of the major healthcare system implications highlighted during the presentation was that even a modest reduction in hospital stay — such as one-half day per patient — could potentially save the United Kingdom National Health Service approximately 170 million pounds annually.
Primary outcomes in the VITAL trial included:
• Days alive and at home 30 days after surgery
• Survival
• Quality of postoperative recovery
Secondary outcomes included:
• Longer-term “days alive and at home” assessments
• Six-month mortality
• Patient satisfaction measures
Although full results have not yet been published, the study is expected to provide important insight into whether anesthetic choice meaningfully affects postoperative recovery trajectories and healthcare utilization.
Additional ongoing investigations related to anesthetic technique were also discussed:
• THRIVE trial — evaluating trajectories of recovery after propofol-based TIVA versus volatile anesthesia
• GlucoVITAL study — examining glucose variability and insulin resistance associated with different anesthetic approaches during major noncardiac surgery
These studies reflect growing interest in perioperative medicine regarding whether anesthetic management influences not only intraoperative conditions but also long-term recovery, metabolic function, and patient-centered outcomes.
Because these findings were presented during a conference late-breaking session, full peer-reviewed publication is still pending.
Key Points
• VITAL compared volatile anesthesia versus TIVA in adults undergoing major noncardiac surgery
• The trial focused on clinically meaningful recovery outcomes such as “days alive and at home”
• Investigators suggested that even small reductions in hospital stay could produce major healthcare cost savings
• Secondary outcomes included six-month mortality and patient satisfaction
• Additional related studies include THRIVE and GlucoVITAL
• Full study results have not yet been published and remain conference-presented data
Thank you to IARS and SOCCA for allowing us to summarize and share these important perioperative medicine conference findings.