Efficacy and Safety of Sufentanil-Propofol Versus Remifentanil-Propofol as Anesthesia in Patients Undergoing Craniotomy: A Meta-Analysis

Abstract

In this study, we aimed to evaluate the efficacy and safety of sufentanil-propofol (SF) versus remifentanil-propofol (RF) as maintenance therapy for anesthesia in patients undergoing craniotomy. Randomized controlled studies on SF and RF as anesthesia for craniotomy were searched in electronic databases such as PubMed, Web of Science, Cochrane Library, Embase, CNKI, and Wanfang Data. All studies were published up to December 31, 2017. The primary outcomes were wake-up time, extubation time, and pain score. The secondary outcomes were heart rate, mean arterial pressure (MAP), and adverse reactions. In this meta-analysis, 14 studies involving 927 patients were investigated. Compared with the SF group, RF could significantly reduce the wake-up time and extubation time after craniotomy (P= 0.02, standardized mean difference [SMD], 1.19; 95% confidence interval [CI], 0.21-2.18; P= 0.0001; SMD, 1.87; 95% CI, 0.90-2.83, respectively). Meanwhile, SF had better efficacy to alleviate postoperative pain than RF (P= 0.001; SMD, 2.10; 95% CI,-3.37 to-0.82). However, there were no obvious differences in improving heart rate and MAP between the 2 groups (P= 0.46; SMD, 0.17; 95% CI,-0.28 to 0.62; P=0.43; SMD, 0.16; 95% CI,-0.54 to 0.23, respectively). Moreover, there were no significant differences in the incidents of nausea and vomiting, shivering, fidgeting, and respiratory depression between the SF and RF groups. RF as anesthesia for craniotomy had better effects in reducing the time of postoperative wake-up and extubation and significantly alleviating pain. Moreover, there were no significant differences in the incidence of adverse reactions between the 2 groups. The findings will prove beneficial for the rational use of clinical anesthetic drugs in the future.