Propofol-based IV anesthesia improves survival during cancer surgery: Study

Taiwan: Cancer patients who receive propofol-based total intravenous anesthesia (TIVA) versus volatile anesthesia during surgery have better overall survival, finds a recent study in the journal Anesthesia & Analgesia. However, according to the authors, there is a need for further large-scaled, high-quality randomized control trials for confirming the findings.

Whether propofol helps in survival benefit versus volatile anesthetics during cancer surgery remains inconclusive. The primary aim of the systematic review and meta-analysis by Ming-Chang Kao, School of Medicine, Tzu Chi University, Hualien, Taiwan, and colleagues, was to to compare the effects of propofol-based TIVA with any volatile anesthesia on long-term oncological outcomes. Secondly, they aimed to compare propofol-based TIVA with specific volatile agents on long-term oncological outcomes.

For the study, the researchers searched the online databases from inception through March 3, 2020. It included randomized control trials and observational studies that compared the effects of propofol-based TIVA and volatile anesthesia on long-term oncological outcomes, which also reported hazard ratios (HR) as effect estimates. 

Using the inverse variance method with a random-effects model, HR and 95% confidence intervals (CI) were calculated. Trial sequential analysis was incorporated to test if the results were subject to a type I or type II error.