{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:59:15Z","timestamp":1790852355569,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":273,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimal anesthetic selection is critical for recovery and patient outcomes in ambulatory surgery. This systematic review and meta\u2010analysis compares propofol\u2010based total intravenous anesthesia (TIVA) with sevoflurane in adults undergoing outpatient procedures, focusing on randomized evidence published since 2014 to reflect contemporary clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a PRISMA\u2010compliant, random\u2010effects meta\u2010analysis of 15 randomized controlled trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091345 randomized participants), published between 2014 and 2025, comparing propofol TIVA with sevoflurane in adults undergoing ambulatory surgery. Primary outcomes were readiness for discharge, postanesthesia care unit (PACU) length of stay (LOS), and emergence time. Secondary outcomes included postoperative nausea and vomiting (PONV) and pain scores, requirement for rescue antiemetics and analgesics, unplanned hospital admissions, and adverse events. All\u2010cause mortality was prespecified for extraction but was not reported in the included trials (PROSPERO: CRD420251151311).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen RCTs were included. For the primary outcomes, discharge readiness was shorter with TIVA in a single core trial (not a pooled meta\u2010analytic estimate) (mean difference [MD] \u22125.8\u2009min; 95% confidence interval [CI] \u221210.63 to \u22120.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), although no significant differences were observed for PACU LOS (MD \u20101.3\u2009min; 95% CI \u22127.3 to 4.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.56). Emergence times were not pooled due to extreme heterogeneity between studies. Regarding secondary outcomes, TIVA was associated with a lower risk of PONV (risk ratio 0.67; 95% CI 0.47\u20130.96; absolute risk difference \u22120.11; approximate number needed to treat 9), with attenuation toward the null under trim\u2010and\u2010fill, and with lower postoperative pain scores (standardized mean difference [SMD] \u22120.30; among VAS 0\u201310 trials, MD \u22120.29 points). Mortality was not reported in any of the included trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Contemporary randomized evidence suggests that propofol TIVA may reduce PONV and yield a small reduction in postoperative pain scores. Evidence regarding discharge readiness, PACU LOS, and emergence is limited or inconsistent and does not support a general claim of faster early recovery with either technique. Anesthetic choice should balance these symptomatic effects against patient factors and institutional resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/anrp\/2531080","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:42:44Z","timestamp":1790851364000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recovery Kinetics and Postoperative Outcomes of Propofol\u2010Based Total Intravenous Anesthesia Versus Sevoflurane in Ambulatory Surgery: A Systematic Review and Meta\u2010Analysis of Randomized Studies"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4113-2400","authenticated-orcid":false,"given":"Ivan","family":"\u0160itum","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and ICU University Hospital Centre Zagreb  Zagreb Croatia  kbc-zagreb.hr"},{"name":"University of Zagreb School of Dental Medicine  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8175-7129","authenticated-orcid":false,"given":"Roberto","family":"Giurazza","sequence":"additional","affiliation":[{"name":"Department of Critical Care AORN Ospedali Dei Colli  Naples Italy  nosm.ca"},{"name":"Department of Woman, Child, General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy  unina2.it"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8283-4097","authenticated-orcid":false,"given":"Martina","family":"Peri\u0107 \u0160itum","sequence":"additional","affiliation":[{"name":"Department of Neurology Dubrava University Hospital  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-7050","authenticated-orcid":false,"given":"Ante","family":"Erceg","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and ICU University Hospital Centre Zagreb  Zagreb Croatia  kbc-zagreb.hr"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8228-8914","authenticated-orcid":false,"given":"Slobodan","family":"Mihaljevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and ICU University Hospital Centre Zagreb  Zagreb Croatia  kbc-zagreb.hr"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6553-4332","authenticated-orcid":false,"given":"Marco","family":"Rispoli","sequence":"additional","affiliation":[{"name":"Department of Critical Care AORN Ospedali Dei Colli  Naples Italy  nosm.ca"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1362-7393","authenticated-orcid":false,"given":"Francesco","family":"Coppolino","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy  unina2.it"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9654-6742","authenticated-orcid":false,"given":"Zoran","family":"Karlovi\u0107","sequence":"additional","affiliation":[{"name":"University of Zagreb School of Dental Medicine  Zagreb Croatia"},{"name":"Department of Dental Medicine University Hospital Centre Zagreb  Zagreb Croatia  kbc-zagreb.hr"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.5281\/ZENODO.17681047"},{"key":"e_1_2_13_2_2","volume-title":"Overview of Major Ambulatory Surgeries Performed in Hospital-Owned Facilities","author":"McDermott K. 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