| Inhalational anaesthesia compared with intravenous anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic surgery |
| Patient or population: adults undergoing transabdominal robotic assisted laparoscopic surgery
Setting: Training and Research Hospital in Turkey and Univerity Hospital in South Korea
Intervention: inhalational anaesthesia
Comparison: intravenous anaesthesia |
| Pain in the PACU (VAS) | Mean pain in the PACU (VAS) was 42.9 | MD 1 lower
(9.82 lower to 7.82 higher) | ‐ | 62
(1 RCT) | ⊕⊕⊝⊝
LOWa | VAS 0 to 100, with higher score indicating greater pain |
| Pain at 1 to 6 hours (VAS) | Mean pain from 1 to 6 hours (VAS) was 42.5 | MD 2.2 lower
(10.62 lower to 6.22 higher) | ‐ | 62
(1 RCT) | ⊕⊕⊝⊝
LOWa | VAS 0 to 100, with higher score indicating greater pain |
| Pain at 6 to 24 hours (VAS) | Mean pain from 6 to 24 hours (VAS) was 34.5 | MD 1 lower
(7.51 lower to 5.51 higher) | ‐ | 62
(1 RCT) | ⊕⊕⊝⊝
LOWa | VAS 0 to 100, with higher score indicating greater pain |
| Presence of nausea | Study population | RR 0.39
(0.19 to 0.80) | 62
(1 RCT) | ⊕⊕⊝⊝
LOWa | |
| 581 per 1000 | 226 per 1000
(110 to 465) |
| Nausea intensity (VNRS) in PACU | Mean nausea intensity (VNRS) in PACU was 0.2 | MD 0.7 lower
(1.35 lower to 0.05 lower) | ‐ | 62
(1 RCT) | ⊕⊕⊝⊝
LOWa | VNRS 0 to 10: 1 to 3 = mild, 4 to 6 = moderate, 7 to 10 = severe, or with retching and vomition |
| Nausea intensity (VNRS) at 1 to 6 hours | Mean nausea intensity (VNRS) at 1 to 6 hours was 0.4 | MD 1.7 lower
(2.59 lower to 0.81 lower) | ‐ | 62
(1 RCT) | ⊕⊕⊝⊝
LOWa | VNRS 0 to 10: 1 to 3 = mild, 4 to 6 = moderate, 7 to 10 = severe, or with retching and vomition |
| Nausea‐vomiting rate at 1 hour | Study population | RR 23.00
(1.44 to 366.71) | 42
(1 RCT) | ⊕⊝⊝⊝
VERY LOWa,b,c | |
| 0 per 1000 | 0 per 1000
(0 to 0) |
| Nausea‐vomiting rate at 3 hours | Study population | RR 2.00
(0.20 to 20.41) | 42
(1 RCT) | ⊕⊝⊝⊝
VERY LOWa,b,c | |
| 48 per 1000 | 95 per 1000
(10 to 972) |
| Adverse effects: increase in IOP during maintenance of anaesthesia | Mean Increase in IOP during maintenance of anaesthesia was 2.1 | MD 3.9 lower
(6.34 lower to 1.46 lower) | ‐ | 66
(1 RCT) | ⊕⊕⊝⊝
LOWa,d | No participants experienced ocular complications No included study reported other adverse events of interest |
| *Risk in the intervention group (and its 95% confidence interval) is based on assumed risk in the comparison group and relative effect of the intervention (and its 95% CI).
CI: confidence interval; IOP: intraocular pressure; MD: mean difference; OR: odds ratio; RR: risk ratio; VAS: visual analogue scale; VNRS: verbal numerical rating scale. |
| GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to the estimate of effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
