Inflammatory Biomarker Levels After Propofol or Sevoflurane Anesthesia: A Meta-analysis.

Area of Science:

• Anesthesiology
• Immunology
• Oncologic Surgery

Background:

• Perioperative inflammation is linked to adverse outcomes like neurocognitive dysfunction and cancer recurrence.
• The clinical impact of anesthetic agents' immunomodulatory effects remains unclear.
• Oncological surgery necessitates understanding inflammatory responses to anesthesia.

Purpose of the Study:

• To compare propofol and sevoflurane regarding perioperative inflammation biomarkers.
• To investigate the correlation between inflammation markers and cognitive outcomes.
• To clarify the role of anesthetic choice in surgical inflammation.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Included studies compared propofol and sevoflurane for general anesthesia.
• Analyzed inflammatory biomarkers (IL-6, IL-10, TNF-α, CRP) and cognitive outcomes.

Main Results:

• 23 studies with 1611 participants were analyzed.
• No significant difference in inflammatory biomarker levels between propofol and sevoflurane.
• High heterogeneity noted, influenced by surgery type, duration, and patient age.
• Limited data on cognition: 4 of 5 studies suggested reduced cognitive decline with propofol.

Conclusions:

• Anesthetic technique did not significantly alter perioperative inflammation.
• Patient and surgical factors likely have a greater impact on inflammation than anesthetic choice.
• Further large-scale trials are needed to confirm propofol's potential cognitive benefits.