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. 2018 Aug 21;2018(8):CD012317. doi: 10.1002/14651858.CD012317.pub2

Gursoy 2015.

Methods RCT, parallel group, single‐centre
Participants Total number of participants: 60
Inclusion criteria
  1. > 65 years of age, ASA I to III, scheduled for laparotomy


Exclusion criteria
  1. Neurological or psychiatric illnesses

  2. Alcohol or substance misuse

  3. Significant fluid loss or electrolyte impairment.

  4. Participants were excluded during the study if they had respiratory or cardiac arrest, ischaemia, cerebral haemorrhage or long‐lasting episodes of hypotension


Type of surgery: laparotomy
Baseline characteristics
TIVA group
  1. Age, mean (SD): 73.17 (± 6.35) years

  2. Gender, M/F: 15/15

  3. ASA grade: not reported


Inhalational maintenance group
  1. Age, mean (SD): 73.27 (± 6.15) years

  2. Gender, M/F: 13/17

  3. ASA grade: not reported


Country: Turkey
Setting: hospital
Interventions TIVA group
Participants: n = 30; 0 reported losses (study authors report use of ITT analysis)
Induction details: propofol 3 mg/kg to 6 mg/kg, remifentanil 1 µg/kg, vecuronium 0.1 mg/kg
Maintenance details: propofol infusion of 12 mg/kg/hour, then 9 mg/kg/hour, then 6 mg/kg/hour over 10 minutes. Remifentainil 0.15 µg/kg/hour to 0.30 µg/kg/hour. 67% air and 33% O2
Inhalational maintenance group
Participants: n = 30; 0 reported losses (study authors report use of ITT analysis)
Induction details: thiopentone 3 mg/kg to 5 mg/kg, vecuronium 0.1 mg/kg IV
Maintenance details: 2% sevoflurane, with 67% N2O/33% O2
Outcomes
  1. Changes in MAP

  2. Cognitive dysfunction (measured at 1, 6, 12, 24 hours postoperatively with MMT)

Notes Funding/declarations of interest: study authors report no conflict of interest
Study dates: not reported
 Note: study report in Turkish. Review authors used Google translate to assist with translation of key paragraphs
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Participants were randomized to groups; no additional details.
Allocation concealment (selection bias) Unclear risk No details
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Not feasible to blind anaesthetists to intervention groups
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk No details
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No apparent loss of study participants
Selective reporting (reporting bias) Unclear risk Study authors do not report clinical trials registration. Not feasible to judge risk of selective outcome reporting
Other bias Low risk No other sources of bias identified