Effects of adding adjuvants to propofol on the post-anesthesia cognitive function in patients undergoing gastroscopy/colonoscopy: a systematic review and meta-analysis

ABSTRACT

Objectives

This study aimed to elucidate the effects of propofol plus adjuvants on postoperative cognitive dysfunction (POCD) and patient satisfaction.

Methods

Studies published up to September 2023 on the Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, Sinomed, PubMed, Embase, Cochrane Library, Web of Science, and Clinictrials.gov websites were searched. Binary summary of results was used for meta-analyses.

Results

We included 18 studies (2691 patients). The combined sedation did not affect the processing speed (ES = 0.02, 95%CI: −0.01, 0.04; I2 = 79.3%, p < 0.001), attention (ES = 0.02, 95%CI: −0.02, 0.05; I2 = 95.0%, p < 0.001), nor working memory (ES = 0.02, 95%CI: −0.03, 0.06; I2 = 94.4%, p < 0.001) in CogState brief battery tool. A significant effect of combined sedation was observed in the domain of visual learning in CogState tool (ES = −0.03, 95%CI: −0.04, −0.02; I2 = 15.8%, p = 0.306). The TDT (ES = 4.96, 95%CI: 2.92, 7.00) indicates that combined sedation would increase error rates in the tests of cognitive function. The DSST (ES = 0.16, 95% CI: −0.44, 0.75) shown that combined sedation does not affect cognitive function. In addition, an insignificant difference in patient satisfaction between combined sedation and propofol alone was observed (ES = −0.03, 95%CI: −0.09, 0.02).

Conclusion

The available evidence suggests that propofol combined with adjuvants may affect POCD but not patient satisfaction.

Registration number

INPLASY2023110092

KEYWORDS:

• Anesthesia
• cognitive function
• colonoscopy
• gastroscopy
• systematic review and meta-analysis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

Liupu Zheng, Rongyuan Zheng and Yi Wang contribute to study concept and design. Liupu Zheng, Mengqian Ye, Jun Ma, Chen Jin, Yan Yang, Haoqi Li and Rongyuan Zheng contribute to data acquisition. Liupu Zheng, Mengqian Ye, Jun Ma, Chen Jin, Yan Yang, Haoqi Li, Rongyuan Zheng and Yi Wang contribute to data analysis and interpretation. Liupu Zheng, Rongyuan Zheng and Yi Wang contribute to draft of the manuscript. Liupu Zheng, Rongyuan Zheng and Yi Wang contribute to draft revising and study supervision. All authors are accountable for all aspects of the work and approve the final version to be published.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14740338.2024.2305705

Additional information

Funding

This paper was not funded.