Effect of desflurane versus sevoflurane in pediatric anesthesia: A meta-analysis

Abstract

Purpose: To compare the effect of desflurane versus sevoflurane in pediatric anesthesia by conducting meta-analysis. Methods: Studies were searched from PubMed, Medline, Springer, Elsevier Science Direct, Cochrane Library and Google Scholar up to July 2014. Weighted mean difference (WMD) or risk ratio (RR) and 95% confidence intervals (CIs) were considered as effect sizes. Heterogeneity across studies was assessed by Cochran Q test and I2 statistic. The random effects model was performed in the meta-analysis when heterogeneity was observed, or the fixed effect model was used. Review Manager 5.1 software was applied for the meta-analysis. Results: A total of 11 studies (13 comparisons) involving 1, 273 objects were included in this meta-analysis. No heterogeneity was observed between studies for any comparison but for postoperative extubation time. The results showed significant differences between desflurane and sevoflurane groups for postoperative extubation time (WMD =-3.87, 95%CI =-6.14 to-1.60, P < 0.01), eye opening time (WMD =-1.11, 95%CI =-1.49 to-0.72, P < 0.01), awakening time (WMD =-4.27, 95%CI =-5.28 to-3.26, P < 0.01) and agitation (RR = 1.44, 95%CI = 1.05 to 1.96, P = 0.02). No significant differences (P > 0.05) were detected for discharge from the recovery room, oculocardiac reflex, nausea and vomiting and severe pain. Conclusions: Desflurane may have less adverse effects than sevoflurane when used in pediatric anesthesia with significantly shorter postoperative extubation time, eye opening time and awakening time as well as slighter agitation.