Systematic review evaluates inhalational anesthesia effectiveness and end-tidal control systems, suggesting implications for clinical practice.
Background: Inhalational anesthesia(IA) remains central to modern surgical practice, offering rapid onset, titratability, and reliable safety with agents like sevoflurane and desflurane. Technological innovations such as end-tidal control (EtC) systems enhance precision in anesthetic delivery. However, concerns remain regarding thermoregulation, emergence profiles, and postoperative complications. Methodology: A systematic literature review was conducted across PubMed and Google Scholar to identify clinical studies from January 2020 to June 2025 evaluating IA. Inclusion criteria focused on human clinical trials and observational studies. Five high-quality studies met eligibility criteria based on the scale for the assessment of narrative review articles (SANRA) scores. Results: EtC systems significantly improved target anesthetic delivery and reduced agent consumption. IA was non-inferior to total intravenous anesthesia (TIVA) in intraoperative bleeding and hemodynamic control during endoscopic sinus surgery (ESS). Compared to remimazolam, inhalational agents were associated with lower rates of intraoperative hypothermia. Caffeine did not accelerate emergence in pediatric patients. No significant difference in postoperative delirium incidence was found between remimazolam and standard care. Conclusion: IA continues to offer clinical advantages, especially with advancements like EtC. While its efficacy compares well with TIVA, limitations in thermoregulation and emergence variability remain. Tailored anesthetic strategies based on patient profiles and surgical context are essential. Further studies should focus on long-term outcomes and high-risk patient groups.
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