{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:31:06Z","timestamp":1788939066634,"version":"build-2803163510"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Background and Aims:<\/jats:title>\n Despite its superior blood\u2013gas partition coefficient compared to sevoflurane, use of desflurane in neurosurgery is limited due to concerns about cerebral vasodilation and potential adverse haemodynamic effects. This study aims to systematically evaluate the comparative efficacy and safety of desflurane and sevoflurane in neurosurgical procedures.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A search was performed in the Cochrane Library, Scopus, Europe PMC and Medline databases for articles published until 5 November 2024 using a combination of pertinent keywords. This review includes randomised controlled trials (RCTs) that analyse the comparison between desflurane and sevoflurane in neurosurgery. The risk of bias from each RCT was assessed using the Risk of Bias version 2 tool from Cochrane Collaboration. We utilised random-effects models to evaluate the mean difference (MD) and odds ratio (OR) for the outcomes presented.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Fourteen trials, encompassing 904 patients, were included in the analysis. Our analysis revealed significantly faster recovery profiles with desflurane, including reduced emergence time [MD -2.26; 95% confidence interval (CI): -2.99, -1.52,\n P<\/jats:italic>\n < 0.00001,\n I<\/jats:italic>\n 2<\/jats:sup>\n = 71%], extubation time (MD -3.02; 95% CI: -3.89, -2.15,\n P<\/jats:italic>\n < 0.00001,\n I<\/jats:italic>\n 2<\/jats:sup>\n = 79%) and overall recovery time (MD -3.26; 95% CI: -5.01, -1.51,\n P<\/jats:italic>\n = 0.0003,\n I<\/jats:italic>\n 2<\/jats:sup>\n = 83%), compared to sevoflurane. Desflurane was associated with better postoperative cognitive function, as evidenced by higher short orientation memory concentration test scores \u2013 a measure of attention and memory \u2013 at 15 min (MD: 2.26; 95% CI: 0.13, 4.39,\n P<\/jats:italic>\n = 0.04,\n I<\/jats:italic>\n 2<\/jats:sup>\n = 91%) and 60 min (MD: 0.29; 95% CI: 0.09, 0.50,\n P<\/jats:italic>\n = 0.005,\n I<\/jats:italic>\n 2<\/jats:sup>\n = 0%) after extubation. We did not find any significant difference in the intra- and\/or postoperative events, such as emergence agitation, nausea and vomiting, shivering, hypertension, hypotension, tachycardia, bradycardia, pain and convulsions, between the two groups of intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This study suggests that desflurane anaesthesia offers faster recovery with a similar safety profile to sevoflurane for neurosurgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_1215_24","type":"journal-article","created":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T10:00:22Z","timestamp":1736589622000},"page":"65-77","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of desflurane and sevoflurane as maintenance inhalational anaesthetic agents for adult patients undergoing neurosurgeries: A systematic review and meta-analysis of randomised trials"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6746-4406","authenticated-orcid":false,"given":"Hori","family":"Hariyanto","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6186-0245","authenticated-orcid":false,"given":"Monika","family":"Widiastuti","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4388-973X","authenticated-orcid":false,"given":"Carla Oktaviani","family":"Pandrya","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2970-893X","authenticated-orcid":false,"given":"Kevin Anderson","family":"Surya","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2629-2291","authenticated-orcid":false,"given":"William","family":"Audi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,11]]},"reference":[{"issue":"Suppl 2","key":"R1-20250111","first-page":"S1","article-title":"Introduction: What is neurosurgery?","volume":"17","author":"Barrow","year":"2019","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"R2-20250111","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.3171\/2017.11.JNS171500","article-title":"Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the Global Neurosurgery Initiative at the Program in Global Surgery and Social Change","volume":"130","author":"Dewan","year":"2018","journal-title":"J Neurosurg"},{"key":"R3-20250111","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3390\/biomedicines11020372","article-title":"Neurosurgical anesthesia: Optimizing outcomes with agent selection","volume":"11","author":"Nguyen","year":"2023","journal-title":"Biomedicines"},{"key":"R4-20250111","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.bpa.2020.11.001","article-title":"Role of anaesthesia in neurosurgical enhanced recovery programmes","volume":"35","author":"Khozenko","year":"2021","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"R5-20250111","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1592\/phco.2005.25.12.1773","article-title":"Inhalation anesthesiology and volatile liquid anaesthetics: Focus on isoflurane, desflurane, and sevoflurane","volume":"25","author":"Sakai","year":"2005","journal-title":"Pharmacotherapy"},{"key":"R6-20250111","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4097\/kja.19199","article-title":"Can desflurane be an alternative to sevoflurane in neuroanesthesia?","volume":"72","author":"Lee","year":"2019","journal-title":"Korean J Anesthesiol"},{"key":"R7-20250111","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/j.0001-5172.2004.00361.x","article-title":"Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs","volume":"48","author":"Holmstr\u00f6m","year":"2004","journal-title":"Acta Anaesthesiol Scand"},{"key":"R8-20250111","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1093\/bja\/87.2.193","article-title":"Effects of desflurane on cerebral autoregulation","volume":"87","author":"Bedforth","year":"2001","journal-title":"Br J Anaesth"},{"key":"R9-20250111","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1097\/00000542-200305000-00010","article-title":"The effects of isoflurane and desflurane on intracranial pressure, cerebral perfusion pressure, and cerebral arteriovenous oxygen content difference in normocapnic patients with supratentorial brain tumors","volume":"98","author":"Fraga","year":"2003","journal-title":"Anesthesiology"},{"key":"R10-20250111","doi-asserted-by":"crossref","first-page":"167","DOI":"10.4103\/1658-354X.152866","article-title":"Comparison of intraoperative brain condition, hemodynamics and postoperative recovery between desflurane and sevoflurane in patients undergoing supratentorial craniotomy","volume":"9","author":"Dube","year":"2015","journal-title":"Saudi J Anaesth"},{"key":"R11-20250111","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1055\/s-0043-1768214","article-title":"A prospective, randomized, open-label study comparing recovery characteristics between desflurane and sevoflurane anesthesia in elderly patients undergoing elective supratentorial craniotomy","volume":"10","author":"Sailaja","year":"2023","journal-title":"J Neuroanaesth Crit Care"},{"key":"R12-20250111","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R13-20250111","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"R14-20250111","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"R15-20250111","doi-asserted-by":"crossref","first-page":"287","DOI":"10.4103\/0019-5049.156868","article-title":"Comparative evaluation of propofol, sevoflurane and desflurane for neuroanaesthesia: A prospective randomised study in patients undergoing elective supratentorial craniotomy","volume":"59","author":"Bastola","year":"2015","journal-title":"Indian J Anaesth"},{"key":"R16-20250111","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/ANA.0b013e3181a19c52","article-title":"Early postoperative cognitive recovery and gas exchange patterns after balanced anesthesia with sevoflurane or desflurane in overweight and obese patients undergoing craniotomy: A prospective randomized trial","volume":"21","author":"Bilotta","year":"2009","journal-title":"J Neurosurg Anesthesiol"},{"key":"R17-20250111","first-page":"7","article-title":"Comparative evaluation of perioperative haemodynamics and emergence profile among isoflurane, sevoflurane and desflurane in patients undergoing elective supratentorial craniotomy for space occupying lesion","volume":"3","author":"Dubey","year":"2018","journal-title":"Acad Anesthesiol Int"},{"key":"R18-20250111","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1590\/S0102-865020160090000010","article-title":"Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane","volume":"31","author":"G\u00f6k\u00e7ek","year":"2016","journal-title":"Acta Cir Bras"},{"key":"R19-20250111","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/WNQ.0b013e31818d0f36","article-title":"Anesthesia for craniotomy: Comparison of sevoflurane, desflurane, or isoflurane anesthesia supplemented with an infusion of dexmedetomidine during supratentorial craniotomy","volume":"19","author":"G\u00fcne\u015f","year":"2009","journal-title":"Neurosurg Q"},{"key":"R20-20250111","first-page":"37","article-title":"A comparison of emergence characteristics with the use of isoflurane, sevoflurane and desflurane in patients undergoing spinal surgeries under general anaesthesia","volume":"16","author":"Gupta","year":"2017","journal-title":"IOSR J Dent Med Sci"},{"key":"R21-20250111","doi-asserted-by":"crossref","first-page":"579","DOI":"10.4103\/ajns.AJNS_235_20","article-title":"Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol","volume":"15","author":"Haldar","year":"2020","journal-title":"Asian J Neurosurg"},{"key":"R22-20250111","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1055\/s-0038-1669494","article-title":"Comparison of recovery profile of propofol, sevoflurane, and desflurane anesthesia in transnasal trans-sphenoidal surgery for pituitary tumors: A prospective randomized trial","volume":"5","author":"Kapil","year":"2018","journal-title":"J Neuroanaesth Crit Care"},{"key":"R23-20250111","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1213\/ane.0b013e3181ac1265","article-title":"A comparison between sevoflurane and desflurane anesthesia in patients undergoing craniotomy for supratentorial intracranial surgery","volume":"109","author":"Magni","year":"2009","journal-title":"Anesth Analg"},{"key":"R24-20250111","doi-asserted-by":"crossref","first-page":"524","DOI":"10.4103\/joacp.JOACP_61_16","article-title":"A prospective randomized study comparing recovery following anesthesia with a combination of intravenous dexmedetomidine and desflurane or sevoflurane in spinal surgeries","volume":"33","author":"Patil","year":"2017","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R25-20250111","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1055\/s-0042-1743443","article-title":"Comparison of recovery profiles of patients undergoing endoscopic lumbar discectomy under desflurane, propofol, or sevoflurane anesthesia: A randomized, prospective, clinical, comparative study","volume":"13","author":"Verma","year":"2022","journal-title":"J Neurosci Rural Pract"},{"key":"R26-20250111","first-page":"13","article-title":"A prospective, randomized single-blind study of sevoflurane vs desflurane, with dexmedetomidine, on the intraoperative hemodynamics and postoperative recovery for transsphenoidal pituitary surgery","volume":"3","author":"Wajekar","year":"2018","journal-title":"Res Inno in Anesth"},{"key":"R27-20250111","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S0895-4356(99)00161-4","article-title":"Publication bias in meta-analysis: its causes and consequences","volume":"53","author":"Thornton","year":"2000","journal-title":"J Clin Epidemiol"},{"key":"R28-20250111","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1002\/sim.1461","article-title":"Adjusting for publication bias in the presence of heterogeneity","volume":"22","author":"Terrin","year":"2003","journal-title":"Stat Med"},{"key":"R29-20250111","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/ANA.0000000000000905","article-title":"Clinical effects and adverse events associated with desflurane use in adult patients undergoing supratentorial craniotomy: A systematic review","volume":"36","author":"Gkantinas","year":"2024","journal-title":"J Neurosurg Anesthesiol"},{"key":"R30-20250111","doi-asserted-by":"crossref","first-page":"3031","DOI":"10.1007\/s11695-017-2929-6","article-title":"Comparison of the recovery profile between desflurane and sevoflurane in patients undergoing bariatric surgery-A meta-analysis of randomized controlled trials","volume":"27","author":"Singh","year":"2017","journal-title":"Obes Surg"},{"key":"R31-20250111","doi-asserted-by":"crossref","first-page":"199","DOI":"10.18433\/J31882","article-title":"Effect of desflurane versus sevoflurane in pediatric anesthesia: A meta-analysis","volume":"18","author":"He","year":"2015","journal-title":"J Pharm Pharm Sci"},{"key":"R32-20250111","doi-asserted-by":"crossref","first-page":"110464","DOI":"10.1016\/j.jclinane.2021.110464","article-title":"Sevoflurane versus desflurane for early postoperative vomiting after general anesthesia in hospitalized adults: A systematic review and meta-analysis of randomized controlled trials","volume":"75","author":"Wang","year":"2021","journal-title":"J Clin Anesth"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_1215_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:41:44Z","timestamp":1787773304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_1215_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_1215_24","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-11-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}