A Study Comparing Two Pain Medicines to Make Recovery Safer and More Comfortable After Pituitary Surgery Through the Nose

INTERVENTION: Intervention1: REMIFENTANYL: Running a low dose background infusion of remifentanyl to assess and prevent extubation response in patients undergoing endoscopic Trans nasal trans sphenoidal surgery from induction to extubation Control Intervention1: FENTANYL: Running a low dose background infusion of fentanyl to assess and prevent extubation responses in patients undergoing endoscopic Trans Nasal Trans Sphenoidal surgery and comparing with Remifentanyl from induction to extubation CONDITION: Health Condition 1: E237‐ Disorder of pituitary gland, unspecified PRIMARY OUTCOME: To compare the efficacy of low dose infusions of fentanyl versus remifentanil in attenuating hemodynamic and stress responses defined as a greater than or equal to 20 percent increase in mean arterial pressure or heart rate from baseline during extubation in patients undergoing elective endoscopic trans nasal trans sphenoidal TNTS surgery.Timepoint: End of surgery, at skin closure ; Emergence, when the patient opens their eyes to verbal command ; At extubation ; 2, 5, 10, 15, 30 and 60 minutes after extubation SECONDARY OUTCOME: To assess and compare the severity of cough, incidence of emergence agitation, pain intensity, time to achieve consciousness response to verbal commands and time to extubation, quality of awakening between the two groups.Timepoint: End of surgery, at skin closure ; Emergence, when the patient opens their eyes to verbal command ; At extubation ; 2, 5, 10, 15, 30 and 60 minutes after extubation To assess patient satisfaction using a 5‐point Likert scale at 24 hours postoperativelyTimepoint: 24 hours postoperatively INCLUSION CRITERIA: ASA physical status 1 to 3 Scheduled for elective Endoscopic TNTS surgery in SCTIMST Willing to provide informed consent