Comparison of Intravenous Anesthesia and Inhalational Anesthesia in Pediatric Patients: A Systematic Review

Abstract

ABSTRACT
Background: The administration of anesthesia in pediatric patients requires special consideration due to physiological differences compared to adults. General anesthesia in children can be performed using total intravenous anesthesia (TIVA) or inhalational anesthesia. The selection of an optimal anesthetic technique plays a crucial role in minimizing perioperative complications and improving clinical outcomes.

Objective: To evaluate and compare the effectiveness and safety of intravenous anesthesia versus inhalational anesthesia in pediatric patients.

Methods: A systematic review was conducted using PubMed Central, the Cochrane Library, and Google Scholar databases up to 2025. This systematic review was registered in the PROSPERO database (registration number: 1302933). Studies comparing propofol-based TIVA with inhalational anesthesia, particularly sevoflurane, in pediatric patients (<18 years) were included. Outcomes analyzed included emergence delirium (ED), postoperative nausea and vomiting (PONV), recovery time, and airway complications.

Results: Most studies demonstrated that propofol-based TIVA was associated with a lower incidence of ED and PONV compared to inhalational anesthesia. However, several studies reported faster recovery times with inhalational anesthesia.

Conclusion: TIVA offers advantages in reducing the incidence of ED and PONV in pediatric patients, while inhalational anesthesia remains superior in terms of ease of induction and recovery time under certain clinical conditions.

Keywords: pediatric anesthesia, TIVA, inhalational anesthesia, propofol, sevoflurane.