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Postoperative Recovery Outcomes for Obese Patients Undergoing General Anesthesia: A Meta-Analysis of Randomized
Zhen-Hua Hu1, Zhe Liu1, Gai-Fang Zheng1
1Department of Anesthesiology, Henan Provincial People's Hospital, Henan University, China.
Purpose:
This study was performed to assess the postoperative recovery outcomes in obese patients undergoing general anesthesia.
Methods:
The eligible studies were identified from PubMed, EmBase, and the Cochrane library until December 2020. The standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to calculate the role of desflurane, sevoflurane, and propofol on recovery outcomes, and the analyses using the random-effects model.
Results:
Eleven randomized controlled trials involving 713 obese patients undergoing general anesthesia were selected for final meta-analysis. We noted desflurane was associated with a shorter time to eye-opening than sevoflurane (SMD: -0.86; 95% CI, -1.43 to -0.28; P = 0.003). The use of desflurane with shorter time to extubation as compared with propofol (SMD: -1.13; 95% CI, -1.52 to -0.73; P < 0.001) or sevoflurane (SMD: -1.19; 95% CI, -2.15 to -0.22; P = 0.016), while sevoflurane was associated with longer time to extubation as compared with propofol (SMD: 1.47; 95% CI, 1.03 to 1.91; P < 0.001). Desflurane were associated with shorter time to stating name as compared with propofol (SMD: -1.40; 95% CI, -2.32 to -0.48; P = 0.003) or sevoflurane (SMD: -2.09; 95% CI, -3.33 to -0.85; P = 0.001). In addition, desflurane was associated with a longer time for orientation to place as compared with propofol (SMD: 0.65; 95% CI, 0.22 to 1.07; P = 0.003), while desflurane with shorter time for orientation to place as compared with sevoflurane (SMD: -0.88; 95% CI, -1.46 to -0.30; P = 0.003).
Conclusions:
The use of desflurane could provide better recovery outcomes in obese patients undergoing general anesthesia. Further large-scale trials should be comparison the long-term effectiveness of various anesthetics.
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