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Review
. 2025 Apr 30:30:22.
doi: 10.4103/jrms.jrms_154_24. eCollection 2025.

Effects of sevoflurane and propofol for elderly patients: A systematic review and meta-analysis

Qi Wang  1 , Jing Luan  2 , Wenli Yu  1
Affiliations
Review

Effects of sevoflurane and propofol for elderly patients: A systematic review and meta-analysis

Qi Wang et al. J Res Med Sci. .

Abstract

Background: To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.

Materials and methods: All studies on sevoflurane, propofol, and hyperamylasemia from the establishment of Embase, Ovid, Cochrane Library, and Google Scholar from database establishment to December 2024 were searched. Literatures were screened, and data were extracted on the grounds of inclusion and exclusion criteria. Review Manager (RevMan) (Version 5.4. The Cochrane Collaboration.) was used for statistical analysis. Outcomes assessed included time to spontaneous eye opening, extubation time, incidence rate of postoperative cognitive dysfunction (POCD), postoperative delirium, agitation, nausea and vomiting.

Results: Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening (P = 0.54), the incidence of POCD (P = 0.07), postoperative delirium (P = 0.37), and postoperative nausea and vomiting (P = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time (P < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced (P = 0.04).

Conclusion: There was no difference in time to spontaneous eye-opening, the incidence of POCD, postoperative delirium, postoperative nausea, and vomiting between the sevoflurane and propofol groups. However, compared with propofol, sevoflurane can significantly shorten intubation time. The incidence of postoperative agitation (P = 0.04) was significantly lower in the propofol group compared with sevoflurane.

Keywords: Aged; meta-analysis; postoperative cognitive dysfunction; postoperative nausea and vomiting; propofol; sevoflurane.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The flow diagram about the study retrieval process
Figure 2
Figure 2
Risk of bias assessment in randomized trials and single-arm studies. Green indicates low risk of bias, yellow indicates medium risk of bias, and red indicates high risk of bias
Figure 3
Figure 3
(a) Pooled estimate of the time to spontaneous eye opening (min) between sevoflurane and propofol groups for general anesthesia in elder patients, (b) Pooled estimate of the extubation time (min) between sevoflurane and propofol groups for general anesthesia in in elder patients. CI: Confidence interval, SD: Standard deviation, IV: Intravenous
Figure 4
Figure 4
(a) Pooled estimate of the incidence of postoperative cognitive dysfunction between sevoflurane and propofol groups for general anesthesia in elder patients, (b) Pooled estimate of the incidence of postoperative delirium between sevoflurane and propofol groups for general anesthesia in elder patients, (c) Pooled estimate of the incidence of postoperative agitation between sevoflurane and propofol groups for general anesthesia in elder patients, (d) Pooled estimate of the incidence of postoperative nausea and vomiting between sevoflurane and propofol groups for general anesthesia in elder patients. CI: Confidence interval
Figure 5
Figure 5
Begg’s funnel of included studies. The shape of the funnel plot did not reveal any evidence of obvious asymmetry. Indicating that there was no publication bias that could affect the results of the meta-analysis
See this image and copyright information in PMC

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