Cardiothoracic & vascular anesthesia
Appraisal of Postoperative Outcomes of Volatile and Intravenous Anesthetics: A Network Meta-Analysis of Patients Undergoing Cardiac Surgery
Authors' conclusion
In patients undergoing cardiac surgery, sevoflurane with propofol was associated with decreased ICU LOS compared with propofol monotherapy. Midazolam with propofol increased ICU LOS compared with propofol alone.
Study context
- Population
- Adults (≥18) undergoing cardiac surgery (analyses restricted to cardiac surgery)
- Participants
- 8,085 adults · 53 RCTs
- Comparison
- Volatile and/or intravenous anaesthetic regimens vs propofol monotherapy for maintenance of anesthesia
- Outcome
- Intensive care unit (ICU) length of stay (LOS)
Methodological detailsfrequentist, random-effects, PRISMA-NMA, RoB-2 and CINeMA appraisal
- Frequentist
- Random-effects
- PRISMA-NMA
- RoB-2 and CINeMA appraisal
Pooled result
As reported in the abstract
Each group vs propofolMD, hours (95% CI)
Sevoflurane + propofol
−18.26(−34.78 to −1.73)
Midazolam + propofol
17.51(2.78–32.25)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Myocardial infarctionMidazolam vs Propofol | 1.94 (1.01–3.71) | |
| 0.20.5125Relative risk (log scale) |
- Myocardial infarction: 27 trials (N = 4,080; 10 arms; I2 = 0%)
In-hospital and 30-day mortality, stroke, delirium
- No significant differences across other outcomes
Original publication
Appraisal of Postoperative Outcomes of Volatile and Intravenous Anesthetics: A Network Meta-Analysis of Patients Undergoing Cardiac Surgery. J Cardiothorac Vasc Anesth. Published 17 July 2023. doi:10.
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