Wang Qi, Luan Jing, Yu Wenli
Department of Anesthesiology, Tianjin First Central Hospital, Tianjin, China.
Department of Pain, Tianjin First Central Hospital, Tianjin, China.
J Res Med Sci. 2025 Apr 30;30:22. doi: 10.4103/jrms.jrms_154_24. eCollection 2025.
To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.
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.
Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening ( = 0.54), the incidence of POCD ( = 0.07), postoperative delirium ( = 0.37), and postoperative nausea and vomiting ( = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time ( < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced ( = 0.04).
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 ( = 0.04) was significantly lower in the propofol group compared with sevoflurane.
评估丙泊酚和七氟醚用于老年患者全身麻醉的安全性。
检索了自建库至2024年12月Embase、Ovid、Cochrane图书馆和谷歌学术中所有关于七氟醚、丙泊酚和高淀粉酶血症的研究。筛选文献，并根据纳入和排除标准提取数据。使用Review Manager（RevMan）（第5.4版。Cochrane协作网）进行统计分析。评估的结局指标包括自主睁眼时间、拔管时间、术后认知功能障碍（POCD）发生率、术后谵妄、躁动、恶心和呕吐。
共纳入14项试验进行本次荟萃分析。结果显示，七氟醚组和丙泊酚组在自主睁眼时间（ = 0.54）、POCD发生率（ = 0.07）、术后谵妄（ = 0.37）和术后恶心呕吐（ = 0.8）方面无显著差异。与丙泊酚组相比，七氟醚组的拔管时间显著缩短（ < 0.0001）。相反，与七氟醚相比,丙泊酚组术后躁动的发生率显著降低（ = 0.04）。
七氟醚组和丙泊酚组在自主睁眼时间、POCD发生率、术后谵妄、术后恶心和呕吐方面无差异。然而，与丙泊酚相比，七氟醚可显著缩短插管时间。丙泊酚组术后躁动的发生率（ = 0.04）显著低于七氟醚组。
