Evidence map›Paper›PMID 42121056›Full record

SynthesisBMC anesthesiology2026

Automated end-tidal control versus manual regulation in low-flow volatile anesthesia: a systematic review and meta-analysis.

Ahmed Shaban, Hany A Zaki, Eman E Shaban, Amira Shaban, Ali Elkandow, Mohamed Gafar Abdelrahim, Ahmed S El-Abd, Mohammed F Abosamak

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Ahmed ShabanDepartment of Internal Medicine, Mansoura General Hospital, Mansoura, Egypt.ORCID http://orcid.org/0000-0001-9402-5230
Hany A ZakiDepartment of Emergency Medicine, College of Medicine, Qatar University, Doha, Qatar.ORCID http://orcid.org/0000-0002-3994-7088
Eman E ShabanDepartment of Cardiology, Al Jufairi Diagnosis and Treatment, MOH, Doha, Qatar.ORCID http://orcid.org/0000-0003-0661-9763
Amira ShabanDepartment of Internal Medicine, Mansoura University Hospital, Mansoura , Egypt.ORCID http://orcid.org/0000-0001-9218-4529
Ali ElkandowDepartment of Emergency Medicine, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0003-0949-7722
Mohamed Gafar AbdelrahimDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.ORCID http://orcid.org/0000-0002-7354-8195
Ahmed S El-AbdDepartment of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mohammed F AbosamakDepartment of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt. samakawy10@yahoo.com.ORCID http://orcid.org/0000-0002-1412-304X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn low-flow anesthesia, automated monitoring of end-tidal oxygen (etO

methodsAn electronic search was conducted across four databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus. The retrieved references were then analyzed against the studies' screening and eligibility criteria before the full articles were included in the study. The Review Manager (RevMan 5.4.1) was then used to conduct the statistical analysis of the reported outcomes.

resultsThe electronic search retrieved 965 articles, among which 10 were included in this review. The studies included a pooled sample size of 1269 who underwent surgical procedures under low-flow anesthesia. The analyzed evidence suggests with low certainty that the type of anesthesia control may not have any significant effect on both the anesthesia duration (SMD - 0.00 min; 95% CI [-0.34, 0.34] p = 0.99) and the procedural duration MCA (SMD 0.04 min; 95% CI; 95% CI [-0.26, 0.33] p = 0.80). Moreover, we found with low certainty in the evidence that the amount of sevoflurane consumed may not be significantly different between etCA and MCA (SMD - 0.32 mLs; 95% CI [-0.94, 0.29] p = 0.31). Our narrative synthesis indicated that etCA can potentially improve anesthesia delivery by reducing the required anesthetist interventions and ensuring stable and accurately administered anesthetics.

conclusionThis review found very low-quality evidence suggesting that the type of anesthesia control may not significantly affect anesthesia delivery parameters, such as the amount of anesthesia consumed and procedural and anesthesia duration. The analyses, however, had significant heterogeneity, making the estimates highly unreliable. On the other hand, some studies indicate potential advantages of using etCA, such as reducing the number of interventions required during anesthesia; however, the evidence remains limited, preventing a full exploration of these advantages.

Indexed as

Anesthesia, InhalationAnesthetics, InhalationAutomationHumansOxygenAnesthetics, InhalationOxygenAutomated end-tidalEnd tidal control anesthesiaEnd tidal oxygenLow-flow volatile anesthesiaManual regulation

Identifiers

PMID42121056
PMCPMC13170165

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.