Systematic review with meta-analysis of relative risk of prolonged times to tracheal extubation with desflurane versus sevoflurane or isoflurane
Authors' conclusion
In conclusion, when emergence from general anesthesia with different drugs are compared with sevoflurane or isoflurane, suitable benchmarks quantifying rapidity of emergence are reductions in the incidence of prolonged extubation achieved by desflurane, approximately 65% and 78%, respectively.
Study context
- Population
- Patients in published randomized clinical trials of humans comparing desflurane with sevoflurane or isoflurane67 papers · 78 comparisons
- Participants
- 5,167 patients
- Comparison
- Desflurane vs sevoflurane or isoflurane
- Outcome
- Prolonged time to tracheal extubation (≥15 min from end of surgery or anesthetic discontinuation to extubation in the OR)
Methodological detailsDerSimonian-Laird random effects, Knapp-Hartung adjustment, generalized pivotal methods, Studies of high quality (23/78) or moderate quality (55/78)
- DerSimonian-Laird random effects
- Knapp-Hartung adjustment
- Generalized pivotal methods
- Studies of high quality (23/78) or moderate quality (55/78)
Pooled result
As reported in the abstract
Incidence of prolonged extubation
Relative reduction
65%
95% CI 49%–76%P < 0.0001
Desflurane vs Sevoflurane
Relative reduction
78%
95% CI 58%–89%P = 0.0001
Desflurane vs Isoflurane
Further pooled results
Meta-regression of studies' RR on quality, industry funding, year of publication
- No significant associations (all six meta-regressions)
- P ≥ 0.35
Original publication
Systematic review with meta-analysis of relative risk of prolonged times to tracheal extubation with desflurane versus sevoflurane or isoflurane. J Clin Anesth. Published 21 July 2023. doi:10.
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