Effects of desflurane and sevoflurane on postoperative recovery in elderly patients: a systematic review and meta-analysis

This was a meta-analysis to compare postoperative recovery in elderly patients (aged > 65 years) under sevoflurane (Sev) or desflurane (Des) anesthesia. A comprehensive literature search was performed via the PubMed, Web of Science and Cochrane Central Register of Controlled Trials databases to identify all relevant studies on the impact of Des and Sev on postoperative recovery in elderly patients. Statistical analysis was carried out via Review Manager Software 5.4. Ten studies were included in our analysis ( n = 746). The time of taken to open eyes (mean difference [MD]-1.97, 95% confidence intervals [CI], -3.54 to -0.40; P = 0.041, I 2 = 78%), follow commands ( MD -3.67, 95% CI, − 5.36 to -1.97; P < 0.001; I 2 = 86.8%), extubation time (MD -3.15, 95% CI, -4.44 to -1.85; P < 0.001; I 2 = 72.7%), orientation time (MD -4.65, 95% CI, -5.82 to -3.48; P < 0.001; I 2 = 51.9%) were significantly shorter in the Des group than in the Sev group. Recovery room discharge time (MD -3.27, 95% CI, -6.66 to 0.12; P = 0.06; I 2 = 3.6%) were no significantly difference in the Des and Sev group. There was no significant difference in the incidence of perioperative neurocognitive disorder ((RR = 1.05, 95% CI, 0.80 to 1.37; P = 0.74; I 2 = 0%)) and adverse events (RR = 1.39, 95% CI, 0.97 to1.94, p = 0.06; I 2 = 0%) between Des and Sev groups. Elderly patients recovered significantly faster in the Des group than in the Sev group, and there were no differences in postoperative complications or cognitive function.