Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands

Abstract

Purpose: We performed a meta-analysis to compare the operating room recovery time of desflurane with that of propofol.

Methods: Studies were included in which a) humans were assigned randomly to propofol or desflurane groups without other differences between groups (e.g., induction drugs) and b) mean and standard deviation were reported for extubation time and/or time to follow commands. Since there was heterogeneity of variance between treatment groups in the log-scale (i.e., unequal coefficients of variation of observations in the time scale), generalized pivotal methods for the lognormal distribution were used as inputs of the random effects meta-analyses.

Results: Desflurane reduced the variability (i.e., standard deviation) in time to extubation by 26% relative to propofol (95% confidence interval [CI], 6% to 42%; P = 0.006) and reduced the variability in time to follow commands by 39% (95% CI, 25% to 51%; P < 0.001). Desflurane reduced the mean time to extubation by 21% (95% CI, 9% to 32%; P = 0.001) and reduced the mean time to follow commands by 23% (95% CI, 16% to 30%; P < 0.001).

Conclusions: The mean reduction in operating room recovery time for desflurane relative to propofol was comparable with that shown previously for desflurane relative to sevoflurane. The reduction in variability exceeded that of sevoflurane. Facilities can use the percentage differences when making evidence-based pharmacoeconomic decisions.