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Sevoflurane versus propofol for anesthetic induction: a meta-analysis
1Departments of Anaesthesia and Pharmacy, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Anesthesia and Analgesia
|June 27, 2000
Summary
Propofol and sevoflurane show similar anesthetic induction efficacy. However, propofol is preferred for outpatient surgery due to better patient satisfaction and fewer side effects like nausea and vomiting.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Sevoflurane and propofol are common agents for anesthetic induction.
- Comparing their characteristics is crucial for optimizing patient care in routine procedures.
Purpose of the Study:
- To conduct a meta-analysis comparing sevoflurane and propofol for anesthetic induction and laryngeal mask airway (LMA) insertion.
- To assess key variables including time to unconsciousness, apnea, complications, LMA insertion success, patient satisfaction, and postoperative nausea and vomiting (PONV).
Main Methods:
- A meta-analysis of 12 randomized controlled trials (RCTs) published between January 1992 and October 1999.
- Searched MEDLINE, Embase, and Cochrane Library databases for relevant studies.
- Compared anesthetic induction using sevoflurane/nitrous oxide versus propofol.
Main Results:
- Sevoflurane showed a trend towards higher patient dissatisfaction and greater first-time LMA insertion success.
- Apnea incidence was lower with sevoflurane.
- Postoperative nausea and vomiting (PONV) was significantly more frequent with sevoflurane (P < 0.05), even after controlling for other variables.
Conclusions:
- Sevoflurane and propofol demonstrate comparable efficacy for anesthetic induction.
- Propofol may be the preferred induction agent for routine outpatient surgery due to its favorable induction characteristics, higher patient satisfaction, and lower incidence of PONV.
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