Effects of sevoflurane and propofol on postoperative nausea and vomiting in patients with colorectal cancer placed under general anesthesia: a systematic review and meta-analysis

Liping Wu, Yizhen Li, Junli Si, Liping Wu, Yizhen Li, Junli Si

Abstract

Background: This study sought to explore the effects of sevoflurane and propofol on postoperative nausea and vomiting (PONV) in patients with colorectal cancer (CRC). Sevoflurane inhalation anesthesia has the advantages of short induction time, stable hemodynamic, stable anesthesia maintenance and short recovery time, and its anesthetic effect is similar to that of propofol, so it is worthy of comparative analysis.

Methods: The PubMed, Cochrane, Web of Science, Embase, clinical research register and CQVIP databases were searched to retrieve the data of randomized controlled trials (RCTs) published between October 2000 and October 2021 on the effects of sevoflurane and propofol on nausea and vomiting after laparoscopic surgery in patients with CRC. Applying the inclusion criteria, the literature selection, data extraction, and quality evaluation assessments were carried out for the included articles. The I2 test was used to evaluate the heterogeneity between the studies, and the meta-analysis was performed using RevMan 5.2.6 software provided by Cochrane.

Results: A total of 12 RCTs were included in this meta-analysis. There was statistically significant differences in changes in postoperative heart rate [odds ratio (OR) =3.55, 95% confidence interval (CI): 2.40, 5.27, P<0.00001, I2=0%, Z=6.30], mean artery pressure (MAP) (OR =2.58, 95% CI: 2.04, 3.26, P<0.00001, I2=58%, Z=7.87), the incidence of PONV (OR =1.73, 95% CI: 1.38, 2.17, P<0.00001, I2=46%, Z=4.78), and the incidence of postoperative disturbance of consciousness (OR =2.09, 95% CI: 1.62, 3.07, P<0.00001, I2=63%, Z=5.67) between the experimental group and the control group.

Conclusions: Combining anesthesia with sevoflurane and propofol had good prevention and treatment effects for PONV in patients with CRC who underwent a laparoscopy and had a moderate central sedation effect.

Keywords: Laparoscope; colorectal cancer (CRC); postoperative nausea and vomiting (PONV); propofol; sevoflurane.

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-22-783/coif). The authors have no conflicts of interest to declare.

2022 Journal of Gastrointestinal Oncology. All rights reserved.

Figures

Figure 1
Figure 1
Flow chart of the literature screening.
Figure 2
Figure 2
Literature quality evaluation chart. (A) Risk of bias graph; (B) risk of bias summary.
Figure 3
Figure 3
Funnel plot of publication bias in the articles on (A) postoperative heart rate variability; (B) MAP; (C) the incidence of PONV; and (D) the incidence of postoperative disturbance of consciousness. MAP, mean artery pressure; PONV, postoperative nausea and vomiting; OR, odds ratio; SE, standard error.
Figure 4
Figure 4
Meta-analysis of changes in the postoperative heart rates between the 2 groups. M-H, Mantel-Haenszel; CI, confidence interval.
Figure 5
Figure 5
Meta-analysis of MAP between the 2 groups. M-H, Mantel-Haenszel; CI, confidence interval; MAP, mean artery pressure.
Figure 6
Figure 6
Meta-analysis of the incidence of PONV between the 2 groups. M-H, Mantel-Haenszel; CI, confidence interval; PONV, postoperative nausea and vomiting.
Figure 7
Figure 7
Meta-analysis of the incidence of postoperative disturbance of consciousness between the 2 groups. M-H, Mantel-Haenszel; CI, confidence interval.

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