Cochrane · systematic review · CD012317
Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non‐cardiac surgery
Miller, D, Lewis, SR, Pritchard, MW, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
6
current version
GRADE rated
6
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 66.7%Low 2 · 33.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings TIVA versus inhalational maintenance of anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Postoperative delirium (One study used DRS, three studies used CAM and in one study diagnostic tool was not reported) Time points were up to 4 days postoperatively Summary of findings TIVA vs inhalational maintenance of anaesthesia | OR 0.59 [0.15, 2.26] | 5 studies · 321 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative cognitive dysfunction (9 studies used MMSE, and 2 of these studies used additional diagnostic tools; 1 study used Trail Making Test and additional diagnostic tools; 3 studies did not report diagnostic tools) Time points were up to 30... Summary of findings TIVA vs inhalational maintenance of anaesthesia | OR 0.52 [0.31, 0.87] | 7 studies · 869 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Mortality At 30 days Summary of findings TIVA vs inhalational maintenance of anaesthesia | OR 1.21 [0.33, 4.45] | 3 studies · 271 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Intraoperative hypotension (defined by study authors as change in MAP from baseline) Summary of findings TIVA vs inhalational maintenance of anaesthesia | no estimate extracted | 12 studies · 1145 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Length of stay in PACU (measured in minutes) Summary of findings TIVA vs inhalational maintenance of anaesthesia | no estimate extracted | 8 studies · 567 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Length of hospital stay (measured in days) Summary of findings TIVA vs inhalational maintenance of anaesthesia | no estimate extracted | 4 studies · 175 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |