Sevoflurane versus propofol anesthesia for craniotomy in adults：a systematic review and meta-analysis

doi:10.3969/j.issn.1006-7795.2013.05.020

Abstract

Abstract:

Objective To evaluate the efficacy and safety of sevoflurane and propofol anesthesia for craniotomy in adults.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and other electronic databases were used to collect the randomized controlled trails (RCTs) on sevoflurane in comparison with propofol for the maintenance of anesthesia for craniotomy in adults. The risks of bias in the included studies were assessed in accordance with The Cochrane Handbook for Systematic Reviews of Interventions. After data extraction, Meta-analysis was performed with RevMan software. Results A total of 17 RCTs involving 1 330 patients were included. The results of Meta-analysis demonstrated that compared with sevoflurane anesthesia, propofol tended to provide better brain relaxation [RR=0.95, 95% CI (0.91, 0.24), P=0.02], lower intracranial pressure (ICP) before skull flap removing [MD=3.81, 95%CI (2.80, 4.82), P < 0.000 01] and lower oxygen saturation of jugular vein bulb (SjvO2) [MD=10.24, 95% CI (7.87, 12.61), P < 0.000 01]. It was shown that there were no significant differences between the two groups in adverse events such as intraoperative hypertension, hypotension, tachycardia and bradycardia, and postoperative shivering. In addition, it was indicated that both eye-opening time and extubation time were similar in the two groups. The incidence of postoperative nausea and vomiting (PONV) was lower in propofol group compared to sevoflurane group [RR=1.56, 95% CI (1.16, 2.10), P=0.004]. Conclusion The current evidence shows that intravenous anesthesia with propofol anesthesia provides better brain relaxation, lower ICP before skull flap removing and decreased occurrence of PONV in comparison with sevoflurane.

Key words: sevoflurane, propofol, craniotomy, Meta-analysis

CLC Number:

R614

YU Yun, ZHANG Kaiying, HAN Ruquan. Sevoflurane versus propofol anesthesia for craniotomy in adults：a systematic review and meta-analysis[J]. Journal of Capital Medical University, 2013, 34(5): 733-741.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.05.020

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I5/733

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