Comparison between the effect of epidural anesthesia combined with epidural analgesia and general anesthesia combined with intravenous analgesia on prognosis of ovarian cancer patients

Abstract

Application value of epidural anesthesia combined with epidural analgesia and general anesthesia combined with intravenous analgesia in ovarian cancer surgery was explored. In total 298 ASA I–III grade patients with ovarian cancer, undergoing extensive total hysterectomy and pelvic lymphotomy, were retrospectively analyzed. Patients were divided into two groups: the epidural anesthesia combined with epidural analgesia group (group A, 158 cases), and the general anesthesia combined with intravenous analgesia group (group B, 140 cases). The first exhaust time, incidence of adverse reactions, Aldrete score, and recovery were observed, and the visual analogue scale (VAS) scores during resting, exercise and cough at 24 h after surgery were recorded. Fasting venous blood (2 ml) was drawn at the same time before anesthesia and at 24 h after anesthesia in both groups to determinate cortisol (COR) and C-reactive protein (CRP) levels. The first exhaust time and incidence of adverse reactions in group A were significantly lower than those in group B (P<0.05). The Aldrete score and extubation time (ET) in group A were significantly higher than that in group B. Eye opening time (EOT), recovery orientation time (ROT) and post-anesthesia care unit (PACU) time in group A were significantly lower than those in group B (P<0.05). The VAS scores in group A during resting, exercise and cough were lower than those in group B (P<0.05). Compared with before anesthesia, the levels of COR and CRP increased significantly in both groups at 24 h after anesthesia (P<0.05), while the level of COR and CRP in group A was significantly lower than that in group B, at 24 h after surgery (P<0.05). Epidural anesthesia combined with epidural analgesia has better analgesic effect, higher safety, lower incidence of adverse reactions, and is beneficial to the recovery of patients with ovarian cancer after radical operation when compared with general anesthesia combined with intravenous analgesia.

Early postoperative CRP predicts major complications following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

“…Past studies have shown both increase and decrease in CRP levels with the type of anesthetic agents used during the surgery, or with the post-operative analgesics, anti-hypertensives, beta-blockers etc. [ 23 ], [ 24 ], [ 25 ], [ 26 ], [ 27 ]. As this variable represents a proportional change we can hypothesize that it is less affected by the differences in operative and perioperative care.…”

Malign asitli over kanserinde sitoredüktif cerrahide perioperatif hemodinamik optimizasyon

“…Ovarian cancer patients with ascites carry a significant risk of morbidity and mortality. Therefore, intraoperative fluid therapy is important for both surveillance and prevention of postoperative complications 21 . Amir et al reported that increased intraoperative blood loss and preoperative ascitic fluid amounts increased the duration of postoperative ICU stay and that the operation times were similar in patients admitted to the service or ICU 22 .…”

Effectiveness of the self-fatigue assessment in guiding early postoperative ambulation in gynaecological oncology patients: study protocol for a randomised controlled trial

“…The sample size is determined based on the results of a literature review and pretrial, 23 24 and 552 patients will be included in this study. This sample size is based on the following statistical considerations: the primary outcome hypothesis was that patients with gynaecological oncology were non-inferior to patients with self-fatigue assessment in early postoperative ambulation in terms of time to first postoperative flatus compared with patients with fixed activity distance assessment.…”