Neuroanesthesia & neurocritical care
Efficacy of propofol-based anesthesia against risk of brain swelling during craniotomy: A meta-analysis of randomized controlled studies
Pooled resultResult — go to the resultRelative risk 0.85Authors' conclusion
By reviewing the available evidence, our results demonstrate the beneficial effects of propofol on the risk of brain swelling, ICP, PONV, and intraoperative tachycardia.
Study context
- Population
- Adults undergoing craniotomy
- Participants
- 1,976 adults · 17 randomized controlled trials (RCTs)
- Comparison
- Propofol-based vs volatile-based anaesthesia
- Outcome
- Risk of brain swelling
Pooled result
As reported in the abstract
Relative risk
0.85
P = 0.03
Further pooled results
| Outcome | Mean difference (mmHg) | P value |
|---|---|---|
| ICPI2 = 44%, n = 409 | −4.06 | P < 0.00001 |
Surgical time and blood loss
- No significant differences between the two groups
Other recovery outcomes (e.g., extubation time)
- No significant differences between the two groups
Brain swelling vs individual volatile agents (subgroup)
- Propofol not associated with reduced risk vs individual volatile agents
Brain swelling by craniotomy indication (subgroup)
- Propofol reduced brain swelling in elective but not emergency craniotomy (e.g., TBI)
Safety
| Outcome | RR | P value |
|---|---|---|
| TachycardiaI2 = 0%, n = 822 | 0.54 | P = 0.005 |
| PONVI2 = 19%, n = 1382 | 0.59 | P = 0.002 |
Bradycardia, hypertension, hypotension
- No significant differences between the two groups
Original publication
Efficacy of propofol-based anesthesia against risk of brain swelling during craniotomy: A meta-analysis of randomized controlled studies. J Clin Anesth. Published 24 October 2023. doi:10.
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