ArticleIndian journal of anaesthesia2025
Comparison of propofol and inhalational anaesthetics for brain relaxation in neurosurgery: A systematic review and network meta-analysis.
Article in Indian journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- The graded effect of propofol in electrophysiology-guided navigation during deep brain stimulation surgery.NPJ Parkinson's disease · 2026Article
- Desflurane combined with ciprofol or esketamine improves postoperative symptoms without compromising early neurocognitive recovery after intracranial aneurysm endovascular coiling.Frontiers in medicine · 2026Article
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Authors and funding
3 authors.
Funding
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Abstract
Background and Aims: The impact of anaesthetic agents on brain relaxation during neurosurgical procedures remains debatable. This study aimed to compare propofol and volatile anaesthetics during maintenance anaesthesia in achieving optimal brain relaxation in adults undergoing intracranial surgery. Methods: We searched PubMed, Embase, Cochrane, and EBSCO Open Dissertations databases from inception to February 2024. Randomised controlled trials (RCTs) comparing anaesthetic agents in patients over 18 years old undergoing neurosurgical procedures were included. The primary outcome was the proportion of subjects who achieved satisfactory brain relaxation, as indicated by a score of 1 on the 4-point Brain Relaxation Score (BRS). The revised Cochrane risk of bias tool was used to evaluate the quality of included studies. Risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effects model. The effects on brain relaxation were ranked using the surface under the cumulative ranking (SUCRA). We also evaluated the certainty of evidence using the Confidence in Network Meta-Analysis (CINeMA) online platform. Results: Out of 2,264 articles identified, 11 RCTs involving 1,367 participants were included. The chance of having satisfactory brain relaxation of the following anaesthetics appeared to be lower than propofol: sevoflurane (RR: 0.93; 95% CI: 0.79, 1.09), isoflurane (RR: 0.89; 95% CI: 0.60, 1.34), and desflurane (RR: 0.83; 95% CI: 0.65, 1.07), with moderate certainty of evidence. Propofol had the highest SUCRA ranking (81.4%). Conclusion: Although all anaesthetic agents had similar effects, propofol showed a tendency towards better brain relaxation during neurosurgery. Further robust evidence is required to confirm the potential advantages of propofol.
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