Comparison of effects of different anesthetic methods on prognosis in patients with stage Ⅲ breast cancer
10.3760/cma.j.cn131073.20201225.00311
- VernacularTitle:不同麻醉方式对Ⅲ期初治乳腺癌手术患者预后影响的比较
- Author:
Mohan LI
1
;
Lijian PEI
;
Chen SUN
;
Ling LAN
;
Yuelun ZHANG
;
Zhiyong ZHANG
;
Gang TAN
;
Yuguang HUANG
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院麻醉科 100730
- Keywords:
Nerve block;
Thoracic vertebrae;
Anesthesia, general;
Breast cancer;
Prognosis
- From:
Chinese Journal of Anesthesiology
2021;41(3):300-305
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of different anesthetic methods on the prognosis in the patients with stage Ⅲ breast cancer.Methods:Based on a multicenter randomized controlled trial (NCT00418457), 274 patients with untreated stage Ⅲ breast cancer, aged 18-85 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, were enrolled in the study and assigned to thoracic paravertebral block (TPVB) combined with total intravenous anesthesia group (TPVB+ TIVA group, n=141) and general anesthesia group (GA group, n=133) by computer-generated randomization stratified by study site.The primary outcome parameter of this study was postoperative recurrence rate.The secondary outcome parameters were the degree of postoperative acute pain (assessed using visual analogue scale score), the incidence of postoperative nausea and vomiting (PONV), postoperative hospital stay time, and the incidence of persistent pain after breast cancer surgery (PPBCS) at 6 and 12 months after surgery (assessed using the modified Brief Pain Inventory). Results:Compared with group GA, no significant change was found in the postoperative recurrence rate ( HR=0.711, 95% confidence interval (CI) 0.418-1.210, P=0.209), the degree of postoperative acute pain and the incidence of PONV were decreased (mean difference ( MD) of visual analogue scale score -0.890, 95% CI -1.344--0.436, P<0.001; OR=0.236, 95% CI 0.083-0.674, P=0.007), and no significant change was found in postoperative hospital stay time and the incidence of PPBCS ( HR=1.000, 95% CI 0.778-1.286, P=1.000; OR=2.100, 95% CI 0.599-7.362, P=0.246) in group TPVB+ TIVA. Conclusion:Compared with general anesthesia alone, TPVB combined with total intravenous anesthesia can provide lower degree of postoperative acute pain and lower incidence of PONV, and exert no effects on postoperative recurrence, postoperative hospital stay time and PPBCS in patients with stage Ⅲ breast cancer.
