• Tzu-Tao Wang, Hsiao-Feng Lu, Yan-Yuen Poon, Shao-Chun Wu, Shao-Yun Hou, Min-Hsien Chiang, Kuo-Chuan Hung, and Shih-Wei Hsu.
• Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Ta-Pei Rd., Niao-Song Dist., Kaohsiung City 833, Taiwan. Electronic address: an3sd0c@cgmh.org.tw.
• J Clin Anesth. 2021 Dec 1; 75: 110464.

Study ObjectiveThis systematic review and meta-analysis aimed at assessing the effects of two commonly used anesthetics in general anesthesia (GA), sevoflurane and desflurane, on early postoperative vomiting (POV) in hospitalized adults.DesignSystematic review and meta-analysis of randomized controlled trials (RCTs).SettingEarly postoperative vomiting after GA.PatientsA total of 266 adult patients receiving inpatient surgeries under GA maintained with sevoflurane or desflurane.InterventionsWe searched PubMed, Medline, Cochrane Central Register of Controlled Trials, ScienceDirect, and Embase for eligible RCTs comparing postoperative outcomes following sevoflurane- or desflurane-maintained anesthesia.MeasurementsThe primary outcome was early POV. Secondary outcomes included late POV, early and late postoperative nausea (PON), time to extubation, and emergence time.Main ResultsEight trials were included. There was no significant difference in the risk of early POV (risk ratio [RR] 1.03, 95% confidence interval [CI] 0.64-1.64, p = 0.91). No significant difference in early PON was observed (RR 1.09; 95% CI, 0.77-1.56; p = 0.62). Nevertheless, the incidence of late POV and late PON were significantly lower in the sevoflurane group than that in the desflurane group (RR 0.47, 95% CI 0.23-0.94, p = 0.03; RR 0.45, 95% CI 0.24-0.84, p = 0.01, respectively). The extubation time was longer in the sevoflurane group than in the desflurane group (standardized mean difference [SMD] 0.56, 95% CI 0.14-0.97, p = 0.009). The emergence time of patients in the sevoflurane group was longer than that in those receiving desflurane (SMD 0.76, 95% CI 0.1-1.42, p = 0.02).ConclusionsDesflurane had the same effects on early POV and early PON as sevoflurane. However, the association between late POV and late PON with desflurane was stronger than that with sevoflurane if the effects of opioids were not considered. The desflurane group had shorter time to extubation and emergence time than the sevoflurane group. PROSPERO registration number: CRD42020218988.Copyright © 2021 Elsevier Inc. All rights reserved.

24 keywords...

hide…