title: Emergence and Recovery Characteristics of Five Common Anesthetics in Pediatric Anesthesia: a Network Meta-analysis.
abstract: Desflurane, halothane, isoflurane, propofol, and sevoflurane are widely used anesthetics in pediatric anesthesia. Adverse effect including emergence agitation, postoperative nausea and vomiting, and postoperative pain are common. Prolonged extubation time and emergency time are also troubling anesthesiologists. Previous studies have noted the characteristics of various anesthetics in pediatric anesthesia, while the results were inconclusive and conflicting. In this study, we aimed at performing a comprehensive network meta-analysis concerning the emergence and recovery characteristics of pediatric anesthetics. Relevant articles were retrieved and selected according to our inclusion criteria. Network meta-analysis was performed with a random-effect model within a Bayesian framework. ORs and corresponding 95 % credible intervals were calculated by Markov chain Monte Carlo methods. Node-splitting method was used to calculate the inconsistency. Rank probabilities were assessed by the surface under the cumulative ranking curve (SUCRA). Propofol was recommended as the most efficient and safe anesthetic in pediatric anesthesia with few adverse effects. Desflurane has the highest incidence of emergence agitation and worst recovery characteristics. Halothane was regarded as an efficient anesthetic with the best recovery characteristics, while postoperative nausea and vomiting is a common adverse effect. Isoflurane was reported to be the safest concerning postoperative pain, and cases using sevoflurane in pediatric anesthesia reported the highest incidence of analgesic requirement. Our network meta-analysis demonstrated that propofol was suggested as the first choice in the clinical practice for its efficiency and safe in pediatric anesthesia.
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China. jianrong_guo@yeah.net.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, China.
authors.forename: Xiaoju
authors.initials: X
authors.lastname: Jin
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tao
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, Gongli Hospital, Second Military Medical University, No 219 Miaopu Road, Shanghai, Pudong New Area, 200135, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Zhang
mesh_terms: D060666:Airway Extubation; D000700:Analgesics / Q000494:pharmacology; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D000777:Anesthetics / Q000009:adverse effects / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D020250:Postoperative Nausea and Vomiting / Q000209:etiology
chemical_list: D000700:Analgesics; D000777:Anesthetics
keywords: Adverse effect; Anesthesiology; Pediatric anesthesiology; Pharmacology