Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane

Alex Macario; Frankin Dexter; David Lubarsky

doi:10.1093/ajhp/62.1.63

Back

Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane

Journal article

Peer reviewed

Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane

Alex Macario, Frankin Dexter and David Lubarsky

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Vol.62(1), pp.63-68

01/01/2005

DOI: 10.1093/ajhp/62.1.63

PMID: 15658074

View Online

Abstract

Results of published, randomized controlled trials comparing sevoflurane and desflurane were pooled to measure differences in times until patients obeyed commands, were extubated, were oriented, were discharged from the postanesthesia care unit (PACU), and were ready to be discharged to home, as well as the occurrence of postoperative nausea and vomiting (PONV). We reviewed all randomized clinical trials in MEDLINE through December 18, 2003, with a title or abstract containing the words sevoflurane and desflurane. Two reviewers independently extracted study data from papers that met inclusion criteria. Endpoints were pooled using random-effects meta-analysis. Twenty-two reports of 25 studies (3 reports each described 2 studies) met our inclusion criteria. A total of 746 patients received sevoflurane, and 752 received desflurane. Patients receiving desflurane recovered 1-2 minutes quicker in the operating room than patients receiving sevoflurane. They obeyed commands 1.7 minutes sooner (p < 0.001; 95% confidence interval [CI], 0.7-2.7 minutes), were extubated 1.3 minutes sooner (p = 0.003; 95% CI, 0.4-2.2 minutes), and were oriented 1.8 minutes sooner (p < 0.001; 95% CI, 0.7-2.9 minutes). No significant differences were detected in the phase I or II PACU recovery times or in the rate of PONV. Meta-analysis of studies in which the duration of anesthesia was up to 3.1 hours indicated that patients receiving either desflurane or sevoflurane did not have significant differences in PACU time or PONV frequency. Patients receiving desflurane followed commands, were extubated, and were oriented 1.0-1.2 minutes earlier than patients receiving sevoflurane.

Postoperative Nausea and Vomiting - chemically induced

Postoperative Nausea and Vomiting - epidemiology

Recovery Room

Randomized Controlled Trials as Topic - methods

Humans

Isoflurane - administration & dosage

Middle Aged

Child, Preschool

Isoflurane - adverse effects

Isoflurane - analogs & derivatives

Sevoflurane

Time Factors

Desflurane

Methyl Ethers - adverse effects

Anesthesia Recovery Period

Adult

Isoflurane - pharmacokinetics

Methyl Ethers - pharmacokinetics

Postoperative Care - statistics & numerical data

Aged

Methyl Ethers - administration & dosage

Surgical Procedures, Operative - methods

Details

Title: Subtitle: Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane
Creators: Alex Macario - Departments of Anesthesia and Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94305-5640, USA. amaca@stanford.edu
Frankin Dexter
David Lubarsky
Resource Type: Journal article
Publication Details: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Vol.62(1), pp.63-68
DOI: 10.1093/ajhp/62.1.63
PMID: 15658074
NLM abbreviation: Am J Health Syst Pharm
ISSN: 1079-2082
eISSN: 1535-2900
Publisher: England
Language: English
Date published: 01/01/2005
Academic Unit: Health Management and Policy; Anesthesia
Record Identifier: 9983806261102771

Metrics

27 Record Views

63 Times Cited - Web of Science

See more details