Zhang Jie, Chen Yanlei, Liu Zhiwu, Pan Zhihao
Department of Anesthesia, Yantai Mountain Hospital, Yantai 264001, Shangdong, China.
Chinese Peoples Liberat Army, Dept of Gastroenterology, Hosp970, Joint Logist Support Unit, Yantai 264001, Shangdong, China.
J Oncol. 2022 Aug 29;2022:7299360. doi: 10.1155/2022/7299360. eCollection 2022.
Endoscopic submucosal dissection (ESD) is a minimally invasive technique to completely peel the pathological mucosa from the submucosa under endoscopy, which has been often utilized to treat early gastric cancer. During the operation, anesthesia is required to reduce the discomfort due to the complexity, high risk, and longtime operation of ESD. In this study, we compared different anesthesia methods on anesthetic effect and postoperative pain in patients (≥65 years old) with early gastric cancer during ESD. For this purpose, 60 patients with early gastric cancer who were more than 65 years old were selected from January 2019 to December 2021, where 30 patients treated with simple intravenous general anesthesia were divided into the simple group and 30 patients treated with intravenous combined inhalation general anesthesia were regarded as the composite group. The hemodynamic index, wake-up time, postoperative pain intensity, operation time, and the incidence of adverse reactions were compared between the two groups. For the hemodynamic index before incision, after incision, and at the end of the operation, the mean arterial pressure (MAP) in the composite group was higher than that in the simple group ( < 0.05) and the heart rate (HR) was lower than that in the simple group ( < 0.05). After the ESD operation, the wake-up time and visual analogue scale (VAS) in the composite group were lower than those in the simple group ( < 0.05). In addition, the ESD operation time and incidence of adverse reactions in the composite group was significantly lower than that in the simple group ( < 0.05). These results showed that intravenous combined inhalation general anesthesia had a good anesthetic effect, stable hemodynamics during ESD operation, and slight postoperative pain.
内镜黏膜下剥离术（ESD）是一种在内镜下将病变黏膜从黏膜下层完全剥离的微创技术，常用于治疗早期胃癌。手术过程中，由于ESD操作复杂、风险高且耗时较长，需要进行麻醉以减轻不适。在本研究中，我们比较了不同麻醉方法对老年（≥65岁）早期胃癌患者ESD术中麻醉效果及术后疼痛的影响。为此，选取2019年1月至2021年12月期间60例年龄大于65岁的早期胃癌患者，其中30例接受单纯静脉全身麻醉的患者分为单纯组，30例接受静脉复合吸入全身麻醉的患者作为复合组。比较两组患者的血流动力学指标、苏醒时间、术后疼痛强度、手术时间及不良反应发生率。在切开前、切开时及手术结束时的血流动力学指标方面，复合组的平均动脉压（MAP）高于单纯组（<0.05），心率（HR）低于单纯组（<0.05）。ESD手术后，复合组的苏醒时间和视觉模拟评分（VAS）低于单纯组（<0.05）。此外，复合组的ESD手术时间和不良反应发生率显著低于单纯组（<0.05）。这些结果表明，静脉复合吸入全身麻醉具有良好的麻醉效果，ESD手术期间血流动力学稳定，术后疼痛轻微。
