To compare the anesthetic effects of sevoflurane and propofol in hepatectomy by using Meta-analysis.

Randomized controlled trials (RCTs) regarding anesthetic effects of sevoflurane and propofol in hepatectomy were systematically searched from Cochrane Library, PubMed, Embase, CNKI, Chongqing VIP and Wanfang databases from the inception date to March 2022 by using the keywords of sevoflurane, propofol, hepatectomy and RCT in both English and Chinese. In the sevoflurane group, sevoflurane combined with fentanyl and other analgesics was given, and propofol in combination with fentanyl and other analgesics was delivered in the propofol group. Meta-analysis was conducted by RevMan 5.4 software. The anesthetic effects were compared between two groups.

13 RCTs consisting of 923 patients were enrolled. 460 patients were assigned in the sevoflurane group and 463 cases in the propofol group. Meta-analysis showed that the average arterial pressure after anesthesia and tracheal intubation in the sevoflurane group was significantly lower than that in the propofol group (MD=-5.17, P<0.05). Postoperative levels of ALT, AST and TB in the sevoflurane group were significantly lower than those in the propofol group (MD=-52.70, -41.18, -9.19; P<0.05). Postoperative levels of IL-6,IL-10 and TNF-α in the sevoflurane group were significantly lower compared with those in the propofol group (MD=-6.32, -10.98, -4.25; P<0.05). In the sevoflurane group, the recovery time of spontaneous breathing and the time of eye opening after operation were significantly shorter than those in the propofol group (MD=-5.54, -12.45; P<0.05). Postoperative visual analogue scale (VAS) score in the sevoflurane group was significantly lower than that in the propofol group (SMD=-1.19, P<0.05). There was no significant difference in extubation time between two groups (MD=-12.15, P=0.05).

Compared with propofol, sevoflurane anesthesia in hepatectomy can suppress postoperative secretion of plasma inflammatory cytokines, accelerate the recovery of liver function, contribute to postoperative recovery of anesthesia, yield favorable analgesic effect and bring clinical benefits.