Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2022 Oct;75(5):407-415. doi: 10.4097/kja.22089. Epub 2022 Jul 15.
Epidural analgesia is commonly used for pain control during lung cancer surgery. However, the clinical trends in epidural analgesia, associated factors, and their association with clinical outcomes remain controversial. Therefore, we aimed to investigate the trends, associated factors, and their association with the clinical outcomes of epidural analgesia for lung cancer surgery.
The National Health Insurance Database was used as the data source in a nationwide cohort study. All adult patients who underwent lung cancer surgery between 2011 and 2018 were included.
A total of 60,031 adult patients who underwent surgery for lung cancer were included. Of these, a total of 24,786 patients (41.3%) received epidural analgesia with a mean value of 1.5 days (standard deviation: 2.0 days). Male sex, increased Charlson comorbidity index (CCI), concurrent musculoskeletal disease, and a wider surgical extent were associated with higher odds of epidural analgesia for lung cancer surgery. Compared to open thoracotomy, video-assisted thoracoscopic surgery (VATS) was associated with lower odds of epidural analgesia for lung cancer surgery. Moreover, epidural analgesia was not associated with 30-day mortality, fatal respiratory events, or one-year mortality after lung cancer surgery.
From 2011 to 2018, 41.3% of patients with lung cancer in South Korea received epidural analgesia for lung cancer surgery. Some factors (male sex, increased CCI, concurrent musculoskeletal disease, wider surgical extent, and VATS) were associated with the use of epidural analgesia in lung cancer surgery. However, epidural analgesia was not associated with clinical outcomes after lung cancer surgery.
硬膜外镇痛常用于肺癌手术中的疼痛控制。然而，硬膜外镇痛的临床趋势、相关因素及其与临床结局的关系仍存在争议。因此，我们旨在探讨肺癌手术中硬膜外镇痛的趋势、相关因素及其与临床结局的关系。
本研究使用国家健康保险数据库作为全国性队列研究的数据来源。纳入了 2011 年至 2018 年间接受肺癌手术的所有成年患者。
共纳入 60031 例接受肺癌手术的成年患者。其中，共有 24786 例（41.3%）患者接受了硬膜外镇痛，平均使用时间为 1.5 天（标准差：2.0 天）。男性、增加的 Charlson 合并症指数（CCI）、并存的肌肉骨骼疾病以及更大的手术范围与肺癌手术中硬膜外镇痛的可能性增加相关。与开胸手术相比，电视辅助胸腔镜手术（VATS）与肺癌手术中硬膜外镇痛的可能性降低相关。此外，硬膜外镇痛与肺癌手术后 30 天死亡率、致命性呼吸事件或一年死亡率无关。
2011 年至 2018 年，韩国 41.3%的肺癌患者接受了肺癌手术的硬膜外镇痛。一些因素（男性、CCI 增加、并存的肌肉骨骼疾病、更大的手术范围和 VATS）与肺癌手术中硬膜外镇痛的使用相关。然而，硬膜外镇痛与肺癌手术后的临床结局无关。
