Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials
Abstract Background Obesity is a global epidemic, projected to affect 4 billion people by 2035. Anesthesia regimens, including volatile anesthetics and total intravenous anesthesia (TIVA), impact postoperative outcomes, particularly in obese patients who face increased risks of complications. Volati...
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BMC
2025-03-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
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| Online Access: | https://doi.org/10.1186/s44158-025-00234-1 |
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| author | Sabrina Soledad Domene Daniela Fulginiti Antonia Thompson Vanessa P. Salolin Vargas Laura C. Rodriguez Meraris D. Tolentino Colón Mariela D. Fermin Madera Juan N. Layton María I. Peña Encarnación Victor S. Arruarana Camila Sanchez Cruz Ernesto Calderon-Martínez |
| author_facet | Sabrina Soledad Domene Daniela Fulginiti Antonia Thompson Vanessa P. Salolin Vargas Laura C. Rodriguez Meraris D. Tolentino Colón Mariela D. Fermin Madera Juan N. Layton María I. Peña Encarnación Victor S. Arruarana Camila Sanchez Cruz Ernesto Calderon-Martínez |
| author_sort | Sabrina Soledad Domene |
| collection | DOAJ |
| description | Abstract Background Obesity is a global epidemic, projected to affect 4 billion people by 2035. Anesthesia regimens, including volatile anesthetics and total intravenous anesthesia (TIVA), impact postoperative outcomes, particularly in obese patients who face increased risks of complications. Volatile anesthetics are often associated with higher rates of postoperative nausea and vomiting (PONV), while TIVA may improve recovery but can increase costs and present additional challenges. This systematic review and meta-analysis evaluate the effects of these anesthesia methods on perioperative outcomes, including hemodynamic stability, recovery, and PONV, in this high-risk population. Methods Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in PROSPERO (CRD42024547776) studies were identified through PubMed, Web of Science, Scopus, China National Knowledge Infrastructure, CINDAHL, Cochrane, EMBASE, and Google Scholar. Two reviewers independently extracted data and assessed the risk of bias. A meta-analysis using a random-effects model was conducted. Results Thirteen studies with 1072 participants were included. Inhalational anesthesia significantly increases PONV (RR, 2.09; 95% CI, 1.21–3.60; p = 0.01; I 2 = 34%) and intraoperative heart rate (MD, 3.49; 95% CI, 0.01–6.97; p < 0.01; I 2 = 67.6%) compared to TIVA. Other outcomes, including mean arterial pressure, duration of intensive care unit stay, recovery time, opioid use, and pain, showed no significant differences between TIVA and inhalational anesthesia in the present analysis. Conclusion TIVA appears to improve perioperative outcomes in obese patients by reducing PONV and intraoperative heart rate, highlighting its potential advantages in clinical practice. Further research is needed to address variability and establish evidence-based guidelines for anesthesia management in this high-risk population. Systematic review registration Number in PROSPERO CRD42024547776 |
| format | Article |
| id | doaj-art-2f3d5a6105334bb79f4d12b103141bb1 |
| institution | DOAJ |
| issn | 2731-3786 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj-art-2f3d5a6105334bb79f4d12b103141bb12025-08-20T02:40:43ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862025-03-015111410.1186/s44158-025-00234-1Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trialsSabrina Soledad Domene0Daniela Fulginiti1Antonia Thompson2Vanessa P. Salolin Vargas3Laura C. Rodriguez4Meraris D. Tolentino Colón5Mariela D. Fermin Madera6Juan N. Layton7María I. Peña Encarnación8Victor S. Arruarana9Camila Sanchez Cruz10Ernesto Calderon-Martínez11Universidad Nacional de Mar del PlataPontifical Catholic University of ArgentinaStevens Institute of TechnologyFacultad de Medicina, Universidad WesthillUniversidad de OrienteUniversidad Iberoamericana (UNIBE)Instituto Tecnológico de Santo Domingo (INTEC)Universidad del RosarioInstituto Tecnológico de Santo Domingo (INTEC)Brookdale University Hospital Medical CenterUniversidad Nacional Autonoma de MexicoUniversidad Nacional Autonoma de MexicoAbstract Background Obesity is a global epidemic, projected to affect 4 billion people by 2035. Anesthesia regimens, including volatile anesthetics and total intravenous anesthesia (TIVA), impact postoperative outcomes, particularly in obese patients who face increased risks of complications. Volatile anesthetics are often associated with higher rates of postoperative nausea and vomiting (PONV), while TIVA may improve recovery but can increase costs and present additional challenges. This systematic review and meta-analysis evaluate the effects of these anesthesia methods on perioperative outcomes, including hemodynamic stability, recovery, and PONV, in this high-risk population. Methods Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in PROSPERO (CRD42024547776) studies were identified through PubMed, Web of Science, Scopus, China National Knowledge Infrastructure, CINDAHL, Cochrane, EMBASE, and Google Scholar. Two reviewers independently extracted data and assessed the risk of bias. A meta-analysis using a random-effects model was conducted. Results Thirteen studies with 1072 participants were included. Inhalational anesthesia significantly increases PONV (RR, 2.09; 95% CI, 1.21–3.60; p = 0.01; I 2 = 34%) and intraoperative heart rate (MD, 3.49; 95% CI, 0.01–6.97; p < 0.01; I 2 = 67.6%) compared to TIVA. Other outcomes, including mean arterial pressure, duration of intensive care unit stay, recovery time, opioid use, and pain, showed no significant differences between TIVA and inhalational anesthesia in the present analysis. Conclusion TIVA appears to improve perioperative outcomes in obese patients by reducing PONV and intraoperative heart rate, highlighting its potential advantages in clinical practice. Further research is needed to address variability and establish evidence-based guidelines for anesthesia management in this high-risk population. Systematic review registration Number in PROSPERO CRD42024547776https://doi.org/10.1186/s44158-025-00234-1AnesthesiaTotal intravenousPostoperative nausea and vomitingObesityIntraoperative vital signsInhalational anesthesia |
| spellingShingle | Sabrina Soledad Domene Daniela Fulginiti Antonia Thompson Vanessa P. Salolin Vargas Laura C. Rodriguez Meraris D. Tolentino Colón Mariela D. Fermin Madera Juan N. Layton María I. Peña Encarnación Victor S. Arruarana Camila Sanchez Cruz Ernesto Calderon-Martínez Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials Journal of Anesthesia, Analgesia and Critical Care Anesthesia Total intravenous Postoperative nausea and vomiting Obesity Intraoperative vital signs Inhalational anesthesia |
| title | Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials |
| title_full | Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials |
| title_short | Inhalation anesthesia and total intravenous anesthesia (TIVA) regimens in patients with obesity: an updated systematic review and meta-analysis of randomized controlled trials |
| title_sort | inhalation anesthesia and total intravenous anesthesia tiva regimens in patients with obesity an updated systematic review and meta analysis of randomized controlled trials |
| topic | Anesthesia Total intravenous Postoperative nausea and vomiting Obesity Intraoperative vital signs Inhalational anesthesia |
| url | https://doi.org/10.1186/s44158-025-00234-1 |
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