Evidence map›Paper›PMID 40074622›Full record

SynthesisBritish journal of anaesthesia2025

Safety and recovery profile of patients after inhalational anaesthesia versus target-controlled or manual total intravenous anaesthesia: a systematic review and meta-analysis of randomised controlled trials.

Nicolas Daccache, Yichen Wu, Sean D Jeffries, Joe Zako, Robert Harutyunyan, Eric D Pelletier, Pascal Laferrière-Langlois, Thomas M Hemmerling

2 registry-linked trialsAbstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07294989 recruitingnot on this map

Median Effective Concentration of Ciprofol and Its Correlation With Bispectral Index: A Prospective Observational Study

Typeobservational_patient_registrySponsorPeking University Shenzhen HospitalRan2025 to 2026Enrolled101ConditionsThyroid DiseaseArmsCiprofol
NCT07357480 narecruitingnot on this mapstarted 2026, after this paper: background citation

Comparison of Target-Controlled Infusion Using the Eleveld Model and Manual Total Intravenous Anesthesia on Intraoperative Anesthetic Consumption and Postoperative Pain and Delirium in Supratentorial Surgery

TypeinterventionalSponsorIstanbul University - CerrahpasaRan2026 to 2026Enrolled70ConditionsPostoperative Delirium (POD), Postoperative Pain, PONV, Burst SuppressionArmsTarget Controlled Infusion, Total Intravenous Anesthesia(TIVA)
3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Trial
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  5. Article
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  8. Post-Operative Delirium in Elderly Patients: A Narrative Review.International journal of molecular sciences · 2025
    Review
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nicolas DaccacheFaculty of Medicine, University of Montreal, Montreal, QC, Canada.
Yichen WuDepartment of Surgical Interventional Sciences, McGill University Health Center, Montreal, QC, Canada.
Sean D JeffriesDepartment of Surgical Interventional Sciences, McGill University Health Center, Montreal, QC, Canada; Department of Anesthesia, McGill University, Montreal, QC, Canada.
Joe ZakoFaculty of Medicine, University of Montreal, Montreal, QC, Canada.
Robert HarutyunyanDepartment of Surgical Interventional Sciences, McGill University Health Center, Montreal, QC, Canada; Department of Anesthesia, McGill University, Montreal, QC, Canada.
Eric D PelletierDepartment of Surgical Interventional Sciences, McGill University Health Center, Montreal, QC, Canada.
Pascal Laferrière-LangloisFaculty of Medicine, University of Montreal, Montreal, QC, Canada; Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital, Montréal, QC, Canada; Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, Canada.
Thomas M HemmerlingDepartment of Surgical Interventional Sciences, McGill University Health Center, Montreal, QC, Canada; Department of Anesthesia, McGill University, Montreal, QC, Canada; Department of Surgery, McGill University, Montreal, QC, Canada. Electronic address: thomas.hemmerling@mcgill.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the UK, total intravenous anaesthesia (TIVA) is used in 25% of general anaesthetics and is gaining traction because of its lower environmental impact and effectiveness in reducing postoperative nausea and vomiting (PONV). Although meta-analyses have compared TIVA and inhalational anaesthesia (IA), the optimal delivery method-manual infusion or target-controlled infusion (TCI)-remains underexplored. This review addresses this gap, leveraging the rapidly growing body of evidence to guide optimal anaesthetic practice.

methodsWe searched PubMed, Embase, Cochrane CENTRAL and Web of Science from inception to October 10, 2024. Studies comparing TIVA and IA across several patient-related and efficiency outcomes were included. Meta-analyses were performed for all outcomes. Subgroup analyses were performed to assess the contribution of different factors including a comparison of TCI with manual infusion in TIVA.

resultsIn total, 385 RCTs were included. No significant difference in ClassIntra grade 3-4 adverse events was observed between TIVA and IA (risk ratio [RR]: 1.00, 95% confidence interval [CI]: 0.88-1.12; P=0.97). Subgroup analysis also showed no significant difference for TCI (RR: 0.89, 95% CI: 0.66-1.21; P=0.46) or manual infusion (RR: 1.03, 95% CI: 0.90-1.17; P=0.70) groups. IA was favoured in recovery times and costs, whereas the incidence of PONV and agitation on emergence favoured TIVA. No statistical difference was observed in our other outcomes.

conclusionsTIVA and IA are comparably safe, with TIVA reducing PONV and agitation, whereas IA offers faster recovery and lower costs. The use of TCI in TIVA might decrease postoperative cognitive dysfunction and increase recovery time, highlighting the need for a systematic review directly comparing TCI and manual infusion. SYSTEMATIC REVIEW PROTOCOL: This review was registered prospectively with PROSPERO (CRD42024413368) on October 10, 2024. A single amendment to the title and order of outcomes was performed on November 21, 2024.

Indexed as

Anesthesia, InhalationAnesthesia, IntravenousAnesthesia Recovery PeriodAnesthetics, InhalationHumansPostoperative Nausea and VomitingRandomized Controlled Trials as TopicAnesthetics, Inhalationanaesthetic gasinhalational anaesthesiapharmacokinetic modelspropofolTCITIVA

Identifiers

PMID40074622
PMCPMC12106880

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.