The Effect Of Desflurane-remifentanil Or Sevoflurane-remifentanil On Early Recovery In Elderly Patients: A Meta-analysis Of Randomized Controlled Trials

Objective:We conducted a meta-analysis to evaluate different indexes of the postoperative resuscitation period in elderly patients who received desflurane–remifentanil or sevoflurane–remifentanil,so as to judge the recovery quality of patients and provide a basis for clinical applications.Methods:We searched the Pub Med,Embase,Cochrane Library,China National Knowledge Infrastructure and Wanfang database from establishment to March 2018.The following keywords were used: ‘sevoflurane’,‘desflurane’,‘elderly’,and their alternative words.Read the title,abstract,key words and the full text of the retrieved literature,stepwise selection.The randomized controlled trail of elderly patients who received desflurane–remifentanil or sevoflurane–remifentanil was collected.Additionally,references of the included articles were manually searched,and those that met the inclusion criteria were included.Extracted data were analysed using Review Manager 5.3.Results:Six studies involving 336 patients were included(desflurane group n= 168,sevoflurane group n=168).1.Time to open eyes: six literatures recorded the time to open eyes in the early recovery period.The result showed that it was significantly faster in the desflurane group than in the sevoflurane group,and the difference was statistically significant(P<0.05).2.Time to extubation: six literatures recorded the time to extubation in the recovery period.The result showed that it was significantly faster in the desflurane group than in the sevoflurane group,and the difference was statistically significant(P<0.05).3.Time to orientation: Three literatures recorded the time to recovery orientation.The result indicate that it was faster in the desflurane group than in the sevoflurane group(P<0.05),and the difference was statistically significant(P<0.05).4.Discharging from the recovery room: Three literatures recorded the time to discharge from the recovery room.The result indicate that there was no significant difference between the desflurane and sevoflurane groups(P>0.05).5.Adverse reaction: The incidence of vomiting and agitation was lower in the desflurane group than in the sevoflurane group(P<0.05).There were no significant difference of hypotension and hypertension was found(P>0.05).Conclusion:When combined with remifentanil to maintain anesthesia,desflurane is more effective and safer than sevoflurane in the postoperative recovery quality of elderly patients.1.The time of opening eyes,extubation and recovery orientation in elderly patients with desflurane anesthesia were faster than those in sevoflurane group.2.The incidence of nausea,vomiting and restlessly in elderly patients with desflurane anesthesia were lower than those of sevoflurane group.