Propofol based IV Anesthesia improves survival during cancer
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Cancer patients who receive propofol-based total intravenous anesthesia (TIVA) versus volatile anesthesia during surgery have better overall survival finds a recent study in the journal Anesthesia and Analgesia.

The primary aim of this systematic review and meta-analysis
is to compare the effects of propofol-based total intravenous anesthesia (TIVA) with any volatile anesthesia on long-term oncological outcomes. The secondary aim is to compare propofol-based TIVA with specific volatile agents on long-term oncological outcomes.

Investigators searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library. Randomized control trials and observational studies that compared the effects of propofol-based TIVA and volatile anesthesia on long-term oncological
outcomes, which also reported hazard ratios (HR) as effect estimates, were considered eligible for inclusion. Using the inverse variance method with a random-effects model, HR and 95% confidence intervals (CI) were calculated.

Nineteen retrospective observational studies were included.

--Patients who received propofol-based TIVA during cancer surgery were associated with significantly better overall survival than those who received volatile anesthesia.

--In contrast, no statistically significant difference was observed in recurrence-free survival between patients who received propofol-based TIVA and volatile anesthesia during cancer surgery.

--In the subgroup analysis by different volatile anesthetics, patients who received propofol-based TIVA were associated with better overall survival than those who received desflurane.

--In contrast, there was no statistically significant difference in overall survival between patients who received propofol-based TIVA and those who received sevoflurane.

--In the trial sequential analysis of overall survival, the cumulative Z curve reached the required heterogeneity-adjusted information size and crossed the traditional significance boundary.

--In contrast, in the trial sequential analysis of recurrence-free survival, the cumulative Z curve did not cross the traditional significance boundary.

Conclusively, propofol-based TIVA is generally associated with better overall survival than volatile anesthesia during cancer surgery. Further large-scale, high-quality randomized control trials are warranted to confirm our findings.

Source: file:///C:/Users/NeNiDiNi/Downloads/Anesthesia_and_Long_term_Oncological_Outcomes__A.6.pdf
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