The Effect And Incidence Of Side Effect Of Sevoflurance Versus Propofol For Anesthetic Induction: A Meta-Analysis

Objective:To systematic review the pharmacological effect and side effect of general anesthesia induction with sevoflurane or propofol. Methods:We searched the PubMed, OVID, EMBASE, Cochrane Library, and the Chinese biomedical database (CBM) to obtain studies concerning the effect of sevoflurane versus propofol for anesthetic induction. Methodological quality of reviews used simple evaluate method the Cochrane Collaboration recommended. Odds ratio(OR)and 95% confidence intervals (CI)were calculate. Meta-analyses were conducted using the Cochrane Collaboration's RevMan 4.2 software. Results:We included randomized, controlled trials(RCT) comparing the effect of anesthetic induction used sevoflurane versus propofol.14 RCTs involving 1073 patients were included in our meta-analysis. Odds ratios (OR) assuming random effects were computed in the absence of significant clinical heterogeneity. The time of loss of consciousness (LOC) was marked slower in the sevoflurane group[WMD=5.98,95% CI (3.76,8.20)]; There was a more frequent rate of apnea in the propofol group[OR=0.07,95% CI (0.04,0.15)]; Induction complications were similar in two group[OR=0.75,95% CI (0.52,1.09)]; Time to successful laryngeal mask airway (LMA) insertion was marked slower in the sevoflurane group [WMD=69.54,95% CI (60.32,78.76)]; The success with LMA on the first attempt were similar in two group[OR=0.93,95% CI (0.55,1.57)]; The more frequent incidence of LMA insertion complication is in the propofol group[OR=0.25,95% CI(0.13,0.47)]; The more frequent incidence of PONV appear in the sevoflurane group[OR=11.01,95% CI (5.83,20.79)]; The incidence of patient dissatisfaction was slightly high in the sevoflurane group[OR=2.20,95% CI (1.25,3.88)].Conclusions:Currently available evidences from RCTs support the efficacy of sevoflurane versus propofol for anesthetic induction had similar. Propofol still seems to have advantages as an ideal drug to induce anesthesia, because of the more fast LOC and the more low incidence of PONV and a trend toward patient satisfaction. However, Sevoflurane may be an excellent induction drug with potentially difficult airway patients and high risk of cardiovascular system patients and patient used LMA, because it have low rate of apnea and incidence of LMA insertion complication.In addition, its role in these special situations has been extremely helpful, which in needle-phobic patients or pediatric patients.