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Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 8/2011

01-08-2011 | Reports of Original Investigations

Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands

Authors: Ruth E. Wachtel, PhD, Franklin Dexter, MD, PhD, Richard H. Epstein, MD, Johannes Ledolter, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 8/2011

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Abstract

Purpose

We performed a meta-analysis to compare the operating room recovery time of desflurane with that of propofol.

Methods

Studies were included in which a) humans were assigned randomly to propofol or desflurane groups without other differences between groups (e.g., induction drugs) and b) mean and standard deviation were reported for extubation time and/or time to follow commands. Since there was heterogeneity of variance between treatment groups in the log-scale (i.e., unequal coefficients of variation of observations in the time scale), generalized pivotal methods for the lognormal distribution were used as inputs of the random effects meta-analyses.

Results

Desflurane reduced the variability (i.e., standard deviation) in time to extubation by 26% relative to propofol (95% confidence interval [CI], 6% to 42%; P = 0.006) and reduced the variability in time to follow commands by 39% (95% CI, 25% to 51%; P < 0.001). Desflurane reduced the mean time to extubation by 21% (95% CI, 9% to 32%; P = 0.001) and reduced the mean time to follow commands by 23% (95% CI, 16% to 30%; P < 0.001).

Conclusions

The mean reduction in operating room recovery time for desflurane relative to propofol was comparable with that shown previously for desflurane relative to sevoflurane. The reduction in variability exceeded that of sevoflurane. Facilities can use the percentage differences when making evidence-based pharmacoeconomic decisions.
Appendix
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Footnotes
1
One article was unclear about whether the desflurane and propofol groups had both received nitrous oxide. An e-mail to the author clarified the protocol.
 
Literature
1.
go back to reference Dexter F, Macario A, Manberg PJ, Lubarsky DA. Computer simulation to determine how rapid anesthetic recovery protocols to decrease the time for emergence or increase the phase I postanesthesia care unit bypass rate affect staffing of an ambulatory surgery center. Anesth Analg 1999; 88: 1053-63.PubMed Dexter F, Macario A, Manberg PJ, Lubarsky DA. Computer simulation to determine how rapid anesthetic recovery protocols to decrease the time for emergence or increase the phase I postanesthesia care unit bypass rate affect staffing of an ambulatory surgery center. Anesth Analg 1999; 88: 1053-63.PubMed
2.
go back to reference Macario A, Dexter F. Effect of compensation and patient scheduling on OR labor costs. AORN J 2000; 71(860): 863-9. Macario A, Dexter F. Effect of compensation and patient scheduling on OR labor costs. AORN J 2000; 71(860): 863-9.
3.
go back to reference Abouleish AE, Dexter F, Whitten CW, Zavaleta JR, Prough DS. Quantifying net staffing costs due to longer-than-average surgical case durations. Anesthesiology 2004; 100: 403-12.PubMedCrossRef Abouleish AE, Dexter F, Whitten CW, Zavaleta JR, Prough DS. Quantifying net staffing costs due to longer-than-average surgical case durations. Anesthesiology 2004; 100: 403-12.PubMedCrossRef
4.
go back to reference McIntosh C, Dexter F, Epstein RH. Impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital. Anesth Analg 2006; 103: 1499-516.PubMedCrossRef McIntosh C, Dexter F, Epstein RH. Impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital. Anesth Analg 2006; 103: 1499-516.PubMedCrossRef
5.
go back to reference Dexter F, Epstein RH. Typical savings from each minute reduction in tardy first case of the day starts. Anesth Analg 2009; 108: 1262-7.PubMedCrossRef Dexter F, Epstein RH. Typical savings from each minute reduction in tardy first case of the day starts. Anesth Analg 2009; 108: 1262-7.PubMedCrossRef
6.
go back to reference Vitez TS, Macario A. Setting performance standards for an anesthesia department. J Clin Anesth 1998; 10: 166-75.PubMedCrossRef Vitez TS, Macario A. Setting performance standards for an anesthesia department. J Clin Anesth 1998; 10: 166-75.PubMedCrossRef
7.
go back to reference Dexter F, Bayman EO, Epstein RH. Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesth Analg 2010; 110: 570-80.PubMedCrossRef Dexter F, Bayman EO, Epstein RH. Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesth Analg 2010; 110: 570-80.PubMedCrossRef
8.
go back to reference Agoliati A, Dexter F, Lok J, et al. Meta-analysis of average and variability of time to extubation comparing isoflurane with desflurane or isoflurane with sevoflurane. Anesth Analg 2010; 110: 1433-9.PubMedCrossRef Agoliati A, Dexter F, Lok J, et al. Meta-analysis of average and variability of time to extubation comparing isoflurane with desflurane or isoflurane with sevoflurane. Anesth Analg 2010; 110: 1433-9.PubMedCrossRef
9.
go back to reference Horng HC, Kuo CP, Ho CC, et al. Cost analysis of three anesthetic regimens under auditory evoked potentials monitoring in gynecologic laparoscopic surgery. Acta Anaesthesiol Taiwan 2007; 45: 205-10.PubMed Horng HC, Kuo CP, Ho CC, et al. Cost analysis of three anesthetic regimens under auditory evoked potentials monitoring in gynecologic laparoscopic surgery. Acta Anaesthesiol Taiwan 2007; 45: 205-10.PubMed
10.
go back to reference Akkurt BC, Temiz M, Inanoglu K, et al. Comparison of recovery characteristics, postoperative nausea and vomiting, and gastrointestinal motility with total intravenous anesthesia with propofol versus inhalation anesthesia with desflurane for laparoscopic cholecystectomy: a randomized controlled study. Curr Ther Res E 2009; 70: 94-103.CrossRef Akkurt BC, Temiz M, Inanoglu K, et al. Comparison of recovery characteristics, postoperative nausea and vomiting, and gastrointestinal motility with total intravenous anesthesia with propofol versus inhalation anesthesia with desflurane for laparoscopic cholecystectomy: a randomized controlled study. Curr Ther Res E 2009; 70: 94-103.CrossRef
11.
go back to reference Gokce BM, Ozkose Z, Tuncer B, Pampal K, Arslan D. Hemodynamic effects, recovery profiles, and costs of remifentanil-based anesthesia with propofol or desflurane for septorhinoplasty. Saudi Med J 2007; 28: 358-63.PubMed Gokce BM, Ozkose Z, Tuncer B, Pampal K, Arslan D. Hemodynamic effects, recovery profiles, and costs of remifentanil-based anesthesia with propofol or desflurane for septorhinoplasty. Saudi Med J 2007; 28: 358-63.PubMed
12.
go back to reference Rapp SE, Conahan TJ, Pavlin DJ, et al. Comparison of desflurane with propofol in outpatients undergoing peripheral orthopedic surgery. Anesth Analg 1992; 75: 572-9.PubMedCrossRef Rapp SE, Conahan TJ, Pavlin DJ, et al. Comparison of desflurane with propofol in outpatients undergoing peripheral orthopedic surgery. Anesth Analg 1992; 75: 572-9.PubMedCrossRef
13.
go back to reference Grundmann U, Silomon M, Bach F, et al. Recovery profile and side effects of remifentanil-based anaesthesia with desflurane or propofol for laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2001; 45: 320-6.PubMedCrossRef Grundmann U, Silomon M, Bach F, et al. Recovery profile and side effects of remifentanil-based anaesthesia with desflurane or propofol for laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2001; 45: 320-6.PubMedCrossRef
14.
go back to reference Pendeville PE, Kabongo F, Veyckemans F. Use of remifentanil in combination with desflurane or propofol for ambulatory oral surgery. Acta Anaesthesiol Belg 2001; 52: 181-6.PubMed Pendeville PE, Kabongo F, Veyckemans F. Use of remifentanil in combination with desflurane or propofol for ambulatory oral surgery. Acta Anaesthesiol Belg 2001; 52: 181-6.PubMed
15.
go back to reference Luginbuhl M, Wuthrich S, Petersen-Felix S, Zbinden AM, Schnider TW. Different benefit of bispectal index (BIS) in desflurane and propofol anesthesia. Acta Anaesthesiol Scand 2003; 47: 165-73.PubMedCrossRef Luginbuhl M, Wuthrich S, Petersen-Felix S, Zbinden AM, Schnider TW. Different benefit of bispectal index (BIS) in desflurane and propofol anesthesia. Acta Anaesthesiol Scand 2003; 47: 165-73.PubMedCrossRef
16.
go back to reference Wrigley SR, Fairfield JE, Jones RM, Black AE. Induction and recovery characteristics of desflurane in day case patients: a comparison with propofol. Anaesthesia 1991; 46: 615-22.PubMedCrossRef Wrigley SR, Fairfield JE, Jones RM, Black AE. Induction and recovery characteristics of desflurane in day case patients: a comparison with propofol. Anaesthesia 1991; 46: 615-22.PubMedCrossRef
17.
go back to reference Graham SG, Aitkenhead AR. A comparison between propofol and desflurane anaesthesia for minor gynaecological laparoscopic surgery. Anaesthesia 1993; 48: 471-5.PubMedCrossRef Graham SG, Aitkenhead AR. A comparison between propofol and desflurane anaesthesia for minor gynaecological laparoscopic surgery. Anaesthesia 1993; 48: 471-5.PubMedCrossRef
18.
go back to reference Camci E, Koltka K, Celenk Y, Tugrul M, Pembeci K. Bispectral index-guided desflurane and propofol anesthesia in ambulatory arthroscopy: comparison of recovery and discharge profiles. J Anesth 2006; 20: 149-52.PubMedCrossRef Camci E, Koltka K, Celenk Y, Tugrul M, Pembeci K. Bispectral index-guided desflurane and propofol anesthesia in ambulatory arthroscopy: comparison of recovery and discharge profiles. J Anesth 2006; 20: 149-52.PubMedCrossRef
19.
go back to reference Lopez-Alvarez S, Bonome Gonzalez C, Aymerich Cano H, Alvarez Refojo F, Rodriguez Rodriguez A, Cobian Llamas JM. The effect of propofol vs desflurane on recovery from anesthesia with remifentanil in outpatient surgery (Spanish). Rev Esp Anestesiol Reanim 2001; 48: 370-4.PubMed Lopez-Alvarez S, Bonome Gonzalez C, Aymerich Cano H, Alvarez Refojo F, Rodriguez Rodriguez A, Cobian Llamas JM. The effect of propofol vs desflurane on recovery from anesthesia with remifentanil in outpatient surgery (Spanish). Rev Esp Anestesiol Reanim 2001; 48: 370-4.PubMed
20.
go back to reference Ashworth J, Smith I. Comparison of desflurane with isoflurane or propofol in spontaneously breathing ambulatory patients. Anesth Analg 1998; 87: 312-8.PubMed Ashworth J, Smith I. Comparison of desflurane with isoflurane or propofol in spontaneously breathing ambulatory patients. Anesth Analg 1998; 87: 312-8.PubMed
21.
go back to reference Van Hemelrijck J, Smith I, White PF. Use of desflurane for outpatient anesthesia. A comparison with propofol and nitrous oxide. Anesthesiology 1991; 75: 197-203.PubMedCrossRef Van Hemelrijck J, Smith I, White PF. Use of desflurane for outpatient anesthesia. A comparison with propofol and nitrous oxide. Anesthesiology 1991; 75: 197-203.PubMedCrossRef
22.
go back to reference Song D, Chung F, Wong J, Yogendran S. The assessment of postural stability after ambulatory anesthesia: a comparison of desflurane with propofol. Anesth Analg 2002; 94: 60-4.PubMed Song D, Chung F, Wong J, Yogendran S. The assessment of postural stability after ambulatory anesthesia: a comparison of desflurane with propofol. Anesth Analg 2002; 94: 60-4.PubMed
23.
go back to reference Lebenbom-Mansour MH, Pandit SK, Kothary SP, Randel GI, Levy L. Desflurane versus propofol anesthesia: a comparative analysis in outpatients. Anesth Analg 1993; 76: 936-41.PubMedCrossRef Lebenbom-Mansour MH, Pandit SK, Kothary SP, Randel GI, Levy L. Desflurane versus propofol anesthesia: a comparative analysis in outpatients. Anesth Analg 1993; 76: 936-41.PubMedCrossRef
24.
go back to reference Fredman B, Sheffer O, Zohar E, et al. Fast-track eligibility of geriatric patients undergoing short urologic surgery procedures. Anesth Analg 2002; 94: 560-4.PubMedCrossRef Fredman B, Sheffer O, Zohar E, et al. Fast-track eligibility of geriatric patients undergoing short urologic surgery procedures. Anesth Analg 2002; 94: 560-4.PubMedCrossRef
25.
go back to reference Juvin P, Servin F, Giraud O, Desmonts JM. Emergence of elderly patients from prolonged desflurane, isoflurane, or propofol anesthesia. Anesth Analg 1997; 85: 647-51.PubMed Juvin P, Servin F, Giraud O, Desmonts JM. Emergence of elderly patients from prolonged desflurane, isoflurane, or propofol anesthesia. Anesth Analg 1997; 85: 647-51.PubMed
26.
go back to reference Wilhelm W, Berg K, Langhammer A, Bauer C, Biedler A, Larsen R. Remifentanil in gynecologic laparoscopy. A comparison of consciousness and circulatory effects of a combination with desflurane and propofol (German). Anasthesiol Intensivmed Notfallmed Schmerzther 1998; 33: 552-6.PubMedCrossRef Wilhelm W, Berg K, Langhammer A, Bauer C, Biedler A, Larsen R. Remifentanil in gynecologic laparoscopy. A comparison of consciousness and circulatory effects of a combination with desflurane and propofol (German). Anasthesiol Intensivmed Notfallmed Schmerzther 1998; 33: 552-6.PubMedCrossRef
27.
go back to reference Tang J, White PF, Wender RH, et al. Fast-track office-based anesthesia: a comparison of propofol versus desflurane with antiemetic prophylaxis in spontaneously breathing patients. Anesth Analg 2001; 92: 95-9.PubMedCrossRef Tang J, White PF, Wender RH, et al. Fast-track office-based anesthesia: a comparison of propofol versus desflurane with antiemetic prophylaxis in spontaneously breathing patients. Anesth Analg 2001; 92: 95-9.PubMedCrossRef
28.
go back to reference Coloma M, Zhou T, White PF, Markowitz SD, Forestner JE. Fast-tracking after outpatient laparoscopy: reasons for failure after propofol, sevoflurane, and desflurane anesthesia. Anesth Analg 2001; 93: 112-5.PubMedCrossRef Coloma M, Zhou T, White PF, Markowitz SD, Forestner JE. Fast-tracking after outpatient laparoscopy: reasons for failure after propofol, sevoflurane, and desflurane anesthesia. Anesth Analg 2001; 93: 112-5.PubMedCrossRef
29.
go back to reference Song D, van Vlymen J, White PF. Is the bispectral index useful in predicting fast-track eligibility after ambulatory anesthesia with propofol and desflurane? Anesth Analg 1998; 87: 1245-8.PubMed Song D, van Vlymen J, White PF. Is the bispectral index useful in predicting fast-track eligibility after ambulatory anesthesia with propofol and desflurane? Anesth Analg 1998; 87: 1245-8.PubMed
30.
go back to reference Song D, Joshi GP, White PF. Fast-track eligibility after ambulatory anesthesia: a comparison of desflurane, sevoflurane, and propofol. Anesth Analg 1998; 86: 267-73.PubMed Song D, Joshi GP, White PF. Fast-track eligibility after ambulatory anesthesia: a comparison of desflurane, sevoflurane, and propofol. Anesth Analg 1998; 86: 267-73.PubMed
31.
go back to reference Grottke O, Dietrich PJ, Wiegels S, Wappler F. Intraoperative wake-up test and postoperative emergence in patients undergoing spinal surgery: a comparison of intravenous and inhaled anesthetic techniques using short-acting anesthetics. Anesth Analg 2004; 99: 1521-7.PubMedCrossRef Grottke O, Dietrich PJ, Wiegels S, Wappler F. Intraoperative wake-up test and postoperative emergence in patients undergoing spinal surgery: a comparison of intravenous and inhaled anesthetic techniques using short-acting anesthetics. Anesth Analg 2004; 99: 1521-7.PubMedCrossRef
32.
go back to reference Apfelbaum JL, Lichtor JL, Lane BS, Coalson DW, Korttila KT. Awakening, clinical recovery, and psychomotor effects after desflurane and propofol anesthesia. Anesth Analg 1996; 83: 721-5.PubMed Apfelbaum JL, Lichtor JL, Lane BS, Coalson DW, Korttila KT. Awakening, clinical recovery, and psychomotor effects after desflurane and propofol anesthesia. Anesth Analg 1996; 83: 721-5.PubMed
33.
go back to reference Juvin P, Vadam C, Malek L, Dupont H, Marmuse JP, Desmonts JM. Postoperative recovery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients: a prospective, randomized study. Anesth Analg 2000; 91: 714-9.PubMedCrossRef Juvin P, Vadam C, Malek L, Dupont H, Marmuse JP, Desmonts JM. Postoperative recovery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients: a prospective, randomized study. Anesth Analg 2000; 91: 714-9.PubMedCrossRef
34.
go back to reference Erk G, Erdogan G, Sahin F, Taspinar V, Dikmen B. Anesthesia for laparoscopic cholecystectomy: comparative evaluation–desflurane/sevoflurane vs. propofol. Middle East J Anesthesiol 2007; 19: 553-62.PubMed Erk G, Erdogan G, Sahin F, Taspinar V, Dikmen B. Anesthesia for laparoscopic cholecystectomy: comparative evaluation–desflurane/sevoflurane vs. propofol. Middle East J Anesthesiol 2007; 19: 553-62.PubMed
35.
go back to reference McKay RE, Large MJ, Balea MC, McKay WR. Airway reflexes return more rapidly after desflurane anesthesia than after sevoflurane anesthesia. Anesth Analg 2005; 100: 697-700.PubMedCrossRef McKay RE, Large MJ, Balea MC, McKay WR. Airway reflexes return more rapidly after desflurane anesthesia than after sevoflurane anesthesia. Anesth Analg 2005; 100: 697-700.PubMedCrossRef
36.
go back to reference Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17: 1-12.PubMedCrossRef Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17: 1-12.PubMedCrossRef
37.
go back to reference Higgins JP, White IR, Anzures-Cabrera J. Meta-analysis of skewed data: Combining results reported on log-transformed or raw scales. Stat Med 2008; 27: 6072-92.PubMedCrossRef Higgins JP, White IR, Anzures-Cabrera J. Meta-analysis of skewed data: Combining results reported on log-transformed or raw scales. Stat Med 2008; 27: 6072-92.PubMedCrossRef
38.
go back to reference Rosenberg MS. The file-drawer problem revisited: a general weighted method for calculating fail-safe numbers in meta-analysis. Evolution 2005; 59: 464-8.PubMed Rosenberg MS. The file-drawer problem revisited: a general weighted method for calculating fail-safe numbers in meta-analysis. Evolution 2005; 59: 464-8.PubMed
39.
go back to reference Dexter F. Regional anesthesia does not significantly change surgical time versus general anesthesia - a meta-analysis of randomized studies. Reg Anesth Pain Med 1998; 23: 439-43.PubMed Dexter F. Regional anesthesia does not significantly change surgical time versus general anesthesia - a meta-analysis of randomized studies. Reg Anesth Pain Med 1998; 23: 439-43.PubMed
40.
go back to reference Marcon E, Dexter F. Observational study of surgeons’ sequencing of cases and its impact on postanesthesia care unit and holding area staffing requirements at hospitals. Anesth Analg 2007; 105: 119-26.PubMedCrossRef Marcon E, Dexter F. Observational study of surgeons’ sequencing of cases and its impact on postanesthesia care unit and holding area staffing requirements at hospitals. Anesth Analg 2007; 105: 119-26.PubMedCrossRef
41.
go back to reference Dexter F, Marcon E, Aker J, Epstein RH. Numbers of simultaneous turnovers calculated from anesthesia or operating room information management system data. Anesth Analg 2009; 109: 900-5.PubMedCrossRef Dexter F, Marcon E, Aker J, Epstein RH. Numbers of simultaneous turnovers calculated from anesthesia or operating room information management system data. Anesth Analg 2009; 109: 900-5.PubMedCrossRef
42.
go back to reference Dexter F, Tinker JH. Comparisons between desflurane and isoflurane or propofol on time to following commands and time to discharge: a metaanalysis. Anesthesiology 1995; 83: 77-82.PubMedCrossRef Dexter F, Tinker JH. Comparisons between desflurane and isoflurane or propofol on time to following commands and time to discharge: a metaanalysis. Anesthesiology 1995; 83: 77-82.PubMedCrossRef
43.
go back to reference Macario A, Dexter F, Lubarsky DA. Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane. Am J Health System Pharm 2005; 62: 63-8. Macario A, Dexter F, Lubarsky DA. Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane. Am J Health System Pharm 2005; 62: 63-8.
44.
go back to reference Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane and desflurane: a systematic review. Anesth Analg 2004; 98: 632-41.PubMedCrossRef Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane and desflurane: a systematic review. Anesth Analg 2004; 98: 632-41.PubMedCrossRef
45.
go back to reference Apfelbaum JL, Grasela TH, Hug CC Jr, et al. The initial clinical experience of 1819 physicians in maintaining anesthesia with propofol: characteristics associated with prolonged time to awakening. Anesth Analg 1993; 77: S10-4.PubMed Apfelbaum JL, Grasela TH, Hug CC Jr, et al. The initial clinical experience of 1819 physicians in maintaining anesthesia with propofol: characteristics associated with prolonged time to awakening. Anesth Analg 1993; 77: S10-4.PubMed
46.
go back to reference Olmstead J, Coxon P, Falcone D, Ignas L, Foss P. World class OR turnaround times: secrets uncovered. AORN J 2007; 85: 942-9.PubMedCrossRef Olmstead J, Coxon P, Falcone D, Ignas L, Foss P. World class OR turnaround times: secrets uncovered. AORN J 2007; 85: 942-9.PubMedCrossRef
47.
go back to reference Fraind DB, Slagle JM, Tubbesing VA, Hughes SA, Weinger MB. Reengineering intravenous drug and fluid administration processes in the operating room: step one: task analysis of existing processes. Anesthesiology 2002; 97: 139-47.PubMedCrossRef Fraind DB, Slagle JM, Tubbesing VA, Hughes SA, Weinger MB. Reengineering intravenous drug and fluid administration processes in the operating room: step one: task analysis of existing processes. Anesthesiology 2002; 97: 139-47.PubMedCrossRef
48.
go back to reference Smythe M, Loughlin K, Schad RF, Lucarroti RL. Patient-controlled analgesia versus intramuscular analgesic therapy. Am J Hosp Pharm 1994; 51: 1433-40.PubMed Smythe M, Loughlin K, Schad RF, Lucarroti RL. Patient-controlled analgesia versus intramuscular analgesic therapy. Am J Hosp Pharm 1994; 51: 1433-40.PubMed
49.
go back to reference Krishnamoorthy K, Mathew T. Inferences on the means of lognormal distributions using generalized p-values and generalized confidence intervals. J Stat Plan Infer 2003; 115: 103-21.CrossRef Krishnamoorthy K, Mathew T. Inferences on the means of lognormal distributions using generalized p-values and generalized confidence intervals. J Stat Plan Infer 2003; 115: 103-21.CrossRef
50.
51.
go back to reference Rittenhouse BE, Choiniere M. An economic evaluation of pain therapy after hysterectomy. Patient-controlled analgesia versus regular intramuscular opioid therapy. Int J Technol Assess Health Care 1999; 15: 548-62.PubMed Rittenhouse BE, Choiniere M. An economic evaluation of pain therapy after hysterectomy. Patient-controlled analgesia versus regular intramuscular opioid therapy. Int J Technol Assess Health Care 1999; 15: 548-62.PubMed
52.
go back to reference Mordin M, Anastassopoulos K, van Breda A, et al. Clinical staff resource use with intravenous patient-controlled analgesia in acute postoperative pain management: results from a multicenter, prospective, observational study. J Perianesth Nurs 2007; 22: 243-55.PubMedCrossRef Mordin M, Anastassopoulos K, van Breda A, et al. Clinical staff resource use with intravenous patient-controlled analgesia in acute postoperative pain management: results from a multicenter, prospective, observational study. J Perianesth Nurs 2007; 22: 243-55.PubMedCrossRef
53.
go back to reference Colwell CW Jr, Morris BA. Patient-controlled analgesia compared with intramuscular injection of analgesics for the management of pain after an orthopaedic procedure. J Bone Joint Surg Am 1995; 77: 726-33.PubMed Colwell CW Jr, Morris BA. Patient-controlled analgesia compared with intramuscular injection of analgesics for the management of pain after an orthopaedic procedure. J Bone Joint Surg Am 1995; 77: 726-33.PubMed
54.
go back to reference Krishnamoorthy K, Mathew T, Ramachandran G. Generalized P-values and confidence intervals: a novel approach for analyzing lognormally distributed exposure data. J Occup Environ Hyg 2006; 3: 642-50.PubMedCrossRef Krishnamoorthy K, Mathew T, Ramachandran G. Generalized P-values and confidence intervals: a novel approach for analyzing lognormally distributed exposure data. J Occup Environ Hyg 2006; 3: 642-50.PubMedCrossRef
55.
go back to reference Friedrich JO, Adhikari NK, Beyene J. The ratio of means method as an alternative to mean differences for analyzing continuous outcome variables in meta-analysis: a simulation study. BMC Med Res Methodol 2008; 8: 32.PubMedCrossRef Friedrich JO, Adhikari NK, Beyene J. The ratio of means method as an alternative to mean differences for analyzing continuous outcome variables in meta-analysis: a simulation study. BMC Med Res Methodol 2008; 8: 32.PubMedCrossRef
56.
57.
go back to reference Sidik K, Jonkman JN. A comparison of heterogeneity variance estimators in combining results of studies. Stat Med 2007; 26: 1964-81.PubMedCrossRef Sidik K, Jonkman JN. A comparison of heterogeneity variance estimators in combining results of studies. Stat Med 2007; 26: 1964-81.PubMedCrossRef
Metadata
Title
Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands
Authors
Ruth E. Wachtel, PhD
Franklin Dexter, MD, PhD
Richard H. Epstein, MD
Johannes Ledolter, PhD
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 8/2011
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-011-9519-1

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