Comparison of Volatile Anesthetics Versus Propofol on Postoperative Cognitive Function After Cardiac Surgery: A Systematic Review and Meta-analysis

Abstract

Objective: To compare the effects of volatile anesthetics and propofol on neurocognitive function after cardiac surgery. Design: A systematic review and meta-analysis of randomized controlled trials. Setting: A literature search of PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science databases was conducted. Participants: A total of 10 randomized controlled trials comparing volatile anesthetics and propofol in cardiac surgery were included in the study. Interventions: The standardized mean difference and risk ratio were calculated to estimate pooled effect sizes. Measurements and Main Results: The primary outcome was the postoperative neurocognitive function score, and the secondary outcome was the incidence of delirium after cardiac surgery. The analysis did not show significant differences in postoperative neurocognitive function scores (standardized mean difference −0.06, 95% CI −0.81-0.69; p = 0.879). The incidences of delirium (risk ratio 1.10, 95% CI 0.81-1.50) between the volatile anesthetics and propofol groups were not significant (p = 0.533). Conclusions: Unlike noncardiac surgery, there are no differences between volatile anesthetics and propofol regarding postoperative neurocognitive dysfunction after cardiac surgery. © 2023 Elsevier Inc.