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Objective: To evaluate the effects of combined intravenous and inhalation anesthesia on postoperative immune and cognitive function in cirrhotic patients, particularly those with a background in athletics and fitness. Methods: A systematic literature search was conducted in the Cochrane Library, Web of Science, PubMed, ProQuest, and Chinese biomedical literature databases (Wanfang, Weipu, CNKI) for controlled trials assessing combined intravenous and inhalation anesthesia in cirrhotic patients, with an emphasis on those maintaining an athletic or fitness-oriented lifestyle. The literature was analyzed using RevMan 5.3 software, focusing on exploring the heterogeneity of the studies. Results: Nine research papers were included in the meta-analysis, encompassing a total of 775 subjects, including 382 in the control group and 393 in the experimental group. Among these, a significant portion of the subjects were identified as being involved in regular athletic or fitness activities. Eight papers were prospective studies, and one was retrospective. The meta[1]analysis revealed that combined intravenous and inhalation anesthesia significantly increased CD3+, CD4+, and CD8+ levels, and improved the CD4+/CD8+ ratio, demonstrating enhanced immune function. Additionally, cognitive function improvements were noted [OR: 1.45, 95% CI (1.03, 1.87), P<0.00001]. There were also significant improvements in liver function markers ALT and ALB. Funnel plots indicated no publication bias. Conclusion: Combined intravenous and inhalation anesthesia is effective in enhancing postoperative immune and cognitive functions in cirrhotic patients, with notable benefits observed in those who are athletes or maintain a high level of physical fitness. This finding is crucial in the management of cirrhotic patients with active lifestyles, as it suggests better postoperative outcomes in terms of immune response, cognitive recovery, and liver function improvement. This underscores the importance of considering lifestyle factors, such as athletic activity and fitness levels, in anesthetic decision-making for cirrhotic patients> <0.00001]. There were also significant improvements in liver function markers ALT and ALB. Funnel plots indicated no publication bias. Conclusion: Combined intravenous and inhalation anesthesia is effective in enhancing postoperative immune and cognitive functions in cirrhotic patients, with notable benefits observed in those who are athletes or maintain a high level of physical fitness. This finding is crucial in the management of cirrhotic patients with active lifestyles, as it suggests better postoperative outcomes in terms of immune response, cognitive recovery, and liver function improvement. This underscores the importance of considering lifestyle factors, such as athletic activity and fitness levels, in anesthetic decision-making for cirrhotic patients.
