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全身麻醉与硬膜外联合麻醉对妇科肿瘤手术麻醉管理效果的比较。

Comparison of the effect of general anesthesia and combined epidural anesthesia on the anesthetic management of gynecological oncological surgery.

作者信息

Mehmet İrfan, Kaya Uğur Berna, Çetin Furkan, Taşkum İbrahim, Cesur Mehmet, Ganidağlı Süleyman, Uğur Mete Gürol

机构信息

Gaziantep University Faculty of Medicine, Department of Anesthesiology, Gaziantep, Turkey.

Abdülkadir Yüksel State Hospital, Clinic of Department of Obstetrics and Gynecology, Gaziantep, Turkey.

出版信息

Turk J Obstet Gynecol. 2024 Dec 12;21(4):227-234. doi: 10.4274/tjod.galenos.2024.22623.

Abstract

OBJECTIVE

To evaluate the potential advantages of combined general and epidural anesthesia for major gynecological oncological surgeries.

MATERIALS AND METHODS

The data of 690 gynecological cancer were retrospectively examined, and 223 patients who met the inclusion criteria were included in the study. The patients were divided into two groups: Group G (123 patients who received general anesthesia only) and Group C (100 patients who received combined epidural and general anesthesia. The perioperative follow-up data were comparatively analyzed.

RESULTS

Operation times in Group G were significantly lower than those in Group C (p=0.018). The blood product replacement rate was higher in Group G (p<0.05). Additionally, intraoperative bleeding rates were lower in Group C (p<0.05). Postoperatively, the analgesic requirement time of Group C was significantly later than that of Group G (p=0.0001). The first mobilization time of Group C was substantially earlier (p=0.0001). Thrombosis and cardiac complications were considerably less frequent in group C, although allergic complications were more common (p<0.05). The length of hospital stay was shorter in Group C (p<0.05).

CONCLUSION

Combined epidural and general anesthesia in gynecological oncological surgeries may improve postoperative outcomes, including reduced analgesic requirements, earlier patient mobilization, shorter hospitalization, and decreased rates of complications, particularly cardiovascular and thrombotic events.

摘要

目的

评估全身麻醉联合硬膜外麻醉用于妇科肿瘤大手术的潜在优势。

材料与方法

回顾性分析690例妇科癌症患者的数据,将符合纳入标准的223例患者纳入研究。患者分为两组:G组(123例仅接受全身麻醉的患者)和C组(100例接受硬膜外麻醉联合全身麻醉的患者)。对围手术期随访数据进行比较分析。

结果

G组的手术时间显著低于C组(p = 0.018)。G组的血制品替代率更高(p < 0.05)。此外,C组的术中出血率更低(p < 0.05)。术后,C组的镇痛需求时间显著晚于G组(p = 0.0001)。C组的首次活动时间明显更早(p = 0.0001)。C组的血栓形成和心脏并发症发生率明显更低,尽管过敏并发症更常见(p < 0.05)。C组的住院时间更短(p < 0.05)。

结论

妇科肿瘤手术中硬膜外麻醉联合全身麻醉可能改善术后结局,包括减少镇痛需求、患者更早活动、缩短住院时间以及降低并发症发生率,尤其是心血管和血栓形成事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0ff/11635725/8d47a57f3469/TurkJObstetGynecol-21-227-graph-1.jpg

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