Comparison of volatile anesthetic agent versus propofol on postoperative cognitive function after cardiac surgery: A systematic review and meta-analysis

Objective To compare the effects of volatile anesthetic agents and propofol on neurocognitive function after cardiac surgery. Design A systematic review and meta-analysis of randomized controlled trials (RCTs). Setting A literature search of PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science databases was conducted. Participants A total of 10 RCTs comparing volatile anesthetics and propofol in cardiac surgery were included in the study. Interventions The standard mean difference (SMD) and risk ratio (RR) were calculated to estimate pooled effect sizes. Measurements and Main Results The primary outcome was the postoperative neurocognitive function score, and the secondary outcome was the incidence of delirium after cardiac surgery. The analysis did not show any significant differences in postoperative neurocognitive function scores (SMD, -0.06; 95% confidence interval [CI] -0.81–0.69; p = 0.879). The incidence of delirium (RR, 1.10; 95% CI, 0.81–1.50) between the volatile anesthetics and propofol groups were not significant (p = 0.533). Conclusions In contrast to non-cardiac surgery, there are no differences between volatile agents and propofol in terms of postoperative neurocognitive dysfunction after cardiac surgery.