Clinical Research Papers:
Effect of postoperative analgesia technique on the prognosis of gastric cancer: a retrospective analysis
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Seokyung Shin1, Hyoung-Il Kim2, Na Young Kim1, Ki-Young Lee1, Dong Wook Kim3 and Young Chul Yoo1
1Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seodaemun-gu, Seoul 03722, Korea
2Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul 03722, Korea
3Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Ilsan-donggu, Goyang-si, Gyeonggi-do 10444, Korea
Dong Wook Kim, email: [email protected]
Young Chul Yoo, email: [email protected]
Keywords: analgesia, epidural, analgesia, patient controlled, gastric cancer
Received: July 07, 2017 Accepted: September 25, 2017 Published: October 20, 2017
Background: Whether regional analgesia techniques have favorable impact on prognosis after cancer surgery is unclear, and existing reports show controversial results. The aim of the present study was to evaluate and compare recurrence and mortality between patients that received either intravenous (IV) or epidural patient controlled analgesia (PCA) for pain control after curative surgery for gastric cancer.
Materials and methods: Medical records of patients that underwent curative gastrectomy for gastric cancer between November 2005 and December 2010 were reviewed. Identified patients were categorized according to the use of IV or epidural PCA for postoperative analgesia. Demographic and perioperative variables including type of PCA were analyzed by univariate and multiple regression analysis to investigate any association with recurrence and mortality after surgery. Propensity score matching was done to adjust for selection bias.
Results: Of the 3,799 patients included in this analysis, 374 and 3, 425 patients received IV and epidural PCAs, respectively. No difference in recurrence (HR, 1.092; 95% CI 0.859 to 1.388; P = 0.471) or mortality (HR, 0.695; 95% CI 0.429 to 1.125; P = 0.138) was identified between the use of IV and epidural PCA. Propensity score matching also showed no difference in recurrence (HR, 1.098; 95% CI 0.756 to 1.596; P = 0.623) or mortality (HR, 0.855; 95% CI 0.391 to 1.869; P = 0.695) between the two groups.
Conclusions: Postoperative use of epidural analgesia was not found to be associated with reduced recurrence or mortality after curative surgery in gastric cancer patients. This finding needs to be confirmed with prospective studies in the future.
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