Comparison of early recovery and cognitive function after desflurane and sevoflurane anaesthesia in elderly patients: A meta-analysis of randomized controlled trials

Abstract

Objectives: A meta-analysis to compare postoperative cognitive function and the time to specific recovery events in elderly patients (aged >65 years) anaesthetized with sevoflurane or desflurane.

Methods: A systematic search of the PubMed(®), Embase(®), Cochrane Library and Chinese Biomedical databases was performed using the keywords 'sevoflurane' and 'desflurane'. Data and characteristics of appropriate randomized controlled trials (RCTs) were extracted.

Results: The meta-analysis included five trials (n = 300). The time taken to follow commands (mean difference [MD] -3.27; 95% confidence intervals [CI] -4.95, -1.59), extubation (MD -1.59; 95%CI -2.62, -0.55), orientation (MD -4.31; 95%CI -4.99, -3.62), and recovery room discharge (MD -9.38; 95%CI -13.43, -5.42) were significantly shorter in the desflurane group than in the sevoflurane group. There was no significant between-drug difference in the incidence of postoperative cognitive dysfunction or the time taken to open the eyes.

Conclusions: Desflurane is associated with a faster recovery from general anaesthesia than sevoflurane in elderly patients.

Keywords: Sevoflurane; desflurane; early recovery; postoperative cognitive dysfunction.