|
|
|
|
|
|
|
|
Abstract
Objectives:
Regional anesthesia has been shown to
blunt the response to surgical stress and decrease the use of volatile
anesthetics and the consumption of opioids, which may reduce immune
compromise and potentially delay tumor recurrence. The goal of this
study was to find a possible association between intraoperative regional
anesthesia and decreased cancer recurrence.
Conclusions:
Intraoperative use of epidural anesthesia
was associated with an increased time to tumor recurrence after surgery
in ovarian cancer patients. This may be a result of preservation of the
immune system function.
Methods:
Patients who underwent surgery for ovarian
cancer between January 1, 2000, and October 1, 2006, were included.
Subjects who had optimal surgical debulking (<1.0 cm of remaining
tumor) were evaluated for time to tumor recurrence (carcinoantigen 125
>21 U/mL or computed tomography evidence of disease progression)
and/or death.
Results:
One hundred eighty-two patients were
evaluated; 127 did not receive epidural anesthesia/analgesia. Among the
55 who had epidural catheters placed, 26 were used intraoperatively and
postoperatively; 29 were used only postoperatively.
Cancer recurrence
was documented in 121 patients. The median (interquartile range) time to
recurrence was 40 (25-52) months. The intraoperative use epidural group
had a mean (95% confidence interval) time to recurrence of 73 (56-91)
months, which was longer than either the epidural postoperative group 33
(21-45) months (P = 0.002) or the no-epidural group 38 (30-47) months (P = 0.001). The postoperative-only and no-epidural groups were not different (P
= 0.92). Intraoperative epidural significantly reduced (hazard ratio,
0.37 [95% confidence interval, 0.19-0.73]) tumor recurrence risk.
Conclusions:
Intraoperative use of epidural anesthesia
was associated with an increased time to tumor recurrence after surgery
in ovarian cancer patients. This may be a result of preservation of the
immune system function.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.