Carron Michele, Freo Ulderico, Innocente Federico, Veronese Stefano, Pilati Pierluigi, Jevtovic-Todorovic Vesna, Ori Carlo
Department of Pharmacology and Anesthesiology, University of Padova, Padova, Italy.
Anesth Analg. 2007 Nov;105(5):1500-3, table of contents. doi: 10.1213/01.ane.0000281051.24740.93.
Chemotherapeutic stop-flow perfusion is a new investigational treatment for locally advanced cancers that is usually performed under general anesthesia (GA), and, less frequently, under spinal anesthesia (SA). We designed this clinical trial to compare the clinical profiles of GA and SA for stop-flow perfusion.
Anesthesia and recovery times, scores on visual analog scales for postoperative pain, and postoperative nausea and vomiting, and admission to the postanesthesia care unit were measured in 40 cancer patients who randomly received either GA with propofol, nitrous oxide/sevoflurane, and fentanyl, or SA with bupivacaine hydrochloride for lower limb or pelvic stop-flow perfusion.
GA and SA did not differ in times to achieve home readiness or patient satisfaction. Compared with GA, SA significantly (P < 0.05) reduced anesthesia times (34 vs 16 min), postoperative visual analog scale scores for pain (5 vs 0) and nausea (8 vs 2), and the number of admissions to the postanesthesia care unit (9 vs 0).
For stop-flow perfusion, GA and SA are both effective, but SA provides faster recovery, superior analgesia, and less postoperative nausea and vomiting in the immediate postoperative period.
化疗性停流灌注是一种针对局部晚期癌症的新型研究性治疗方法，通常在全身麻醉（GA）下进行，较少情况下在脊髓麻醉（SA）下进行。我们设计了这项临床试验，以比较GA和SA用于停流灌注时的临床情况。
对40例癌症患者进行了测量，这些患者随机接受丙泊酚、氧化亚氮/七氟醚和芬太尼的GA，或用于下肢或盆腔停流灌注的盐酸布比卡因的SA，测量指标包括麻醉和恢复时间、术后疼痛视觉模拟量表评分、术后恶心和呕吐情况以及进入麻醉后护理单元的情况。
GA和SA在达到出院准备状态的时间或患者满意度方面没有差异。与GA相比，SA显著（P < 0.05）缩短了麻醉时间（34分钟对16分钟）、术后疼痛视觉模拟量表评分（5对0）和恶心评分（8对2），以及进入麻醉后护理单元的次数（9次对0次）。
对于停流灌注，GA和SA都有效，但SA能提供更快的恢复、更好的镇痛效果，且术后早期恶心和呕吐更少。
