The efficacy and safety of desflurane versus sevoflurane in elderly patients during general anaesthesia: a meta-analysis randomized controlled trials

Abstract Background: The objective of the study was to systematically screen the literature and to identify of the results of randomized controlled trials (RCTs) comparing the efficacy and safety of desflurane versus sevoflurane in elderly patients during general anaesthesia. Methods: Databases including PUBMED, EMBASE, Web of Science and Cochrane Library were searched until July 2018 to identify relevant studies. Two authors independently reviewed each study. After literature screening and data extraction, a meta-analysis was conducted using the RevMan 5.2 software. Five RCTs, including 324 patients, met the inclusion criteria and were included in the final analysis. Results: Our pooled analysis showed that elderly patients during desflurane general anaesthesia could reduce time taken to open eyes (SMD, -0.63; 95% CI, -1.23 to -0.03; P=0.04), follow commands (SMD, -0.97; 95% CI, -1.76 to -0.19; P=0.01), extubation (SMD, -0.77; 95% CI, -1.35 to -0.19; P=0.009) and orientation (SMD, -1.49; 95% CI, -2.43 to -0.54). However, there was no difference between desflurane and sevoflurane groups with regard to anesthesia time (SMD, -0.10; 95% CI, -0.35 to 0.15; P=0.43) and the length of postanesthetic care unit (PACU) PACU stay (SMD, -4.65; 95% CI, -10.31 to 1; P=0.11). Conclusions: Our results show that elderly patients during desflurane general anaesthesia offers several potential advantages over anaesthesia in terms of the time to open the eyes, follow commands, extubation and orientation. However both anesthetics appear to be equivalent with regard to the anesthesia time and length of PACU stay. Keywords: Desflurane, sevoflurane, efficacy, safety, elderly patients, meta-analysis