Meta-analysis reveals no significant differences in cognitive function outcomes with sevoflurane and propofol anesthesia in cancer patients, suggesting varying short-term effects.
Background: Both propofol and sevoflurane, commonly used anesthetics, may cause brain oxygen metabolism abnormalities potentially linked to postoperative cognitive dysfunction (POCD), though their precise relationship with POCD requires further study. Objective: To systematically evaluate sevoflurane inhalation versus propofol intravenous anesthesia effects on postoperative cognitive function in cancer patients. Methods: We searched PubMed, EMbase, Cochrane Library, CBM, CNKI, Wanfang, VIP, and Chinese Biomedical Literature databases (from January 10, 2023) using keywords including Anaesthesia, Anesthetic Agents, Neoplasm, Cancer, Cognition, and Cognitive Function. Only human randomized controlled trials (RCTs) and prospective cohort studies were included; no language restrictions applied. Results: 41 studies met criteria (40 RCTs, 1 cohort), involving 4342 patients (2171 sevoflurane, 2171 propofol). Meta-analysis: Overall POCD incidence showed no significant difference between groups. Subgroup analysis revealed significantly increased POCD with sevoflurane at unspecified postoperative times. No significant differences were found at 6 hours, 7 days, or 3 months. Significantly decreased POCD with sevoflurane was observed at 1 and 3 days postoperatively. Preoperative Mini-Mental State Examination (MMSE) scores showed no significant difference. Overall postoperative MMSE scores also showed no significant difference. However, MMSE scores were significantly lower in the sevoflurane group at 1, 3, 6, and 12 hours postoperatively. No significant differences were found at 1, 2, 3, 5, 7 days, or 1 month. Conclusion subsections: Sevoflurane and propofol anesthesia may exert differing short-term, but not long-term, negative impacts on cognitive function in cancer patients. Overall, no significant difference exists in their effects on postoperative cognitive function.
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