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Effect of different anesthetic techniques on the prognosis of hepatocellular carcinoma after hepatectomy

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Author:
No author available
Journal Title:
National Medical Journal of China
Issue:
22
DOI:
10.3760/cma.j.issn.0376-2491.2017.22.009
Key Word:
癌,肝细胞;麻醉,静脉;麻醉,吸入;Carcinoma,hepatocellular;Anesthesia,intravenous;Anesthesia,inhalation

Abstract: Objective To investigate the influence of different anesthetic techniques on the prognosis of hepatocellular carcinoma (HCC) after hepatectomy.Methods A total of 185 consecutive patients with HCC confirmed underwent surgery in Cancer Hospital,Chinese Academy of Medical Sciences were recruited from January 2006 to January 2008.The patients were assessed as American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ,with body mass index (BMI) (22.8 ± 4.6)kg/m2.There were 169 males,with an average age of 56 years old and 16 females,with an average age of 53 years old.According to the different anesthesia methods,185 patients were divided into two groups:total intravenous anesthesia group (TIVA) (n =53) and intravenous-inhalation combined anesthesia group (n =132).Postoperative pain and adverse reactions were compared in recent follow-up,prognosis were compared in long-term follow-up.Results Recent follow-up showed that the NRS scores 2 hours after operation in TIVA group was 2.0 (0-2.0),whereas those in intravenous-inhalation combined anesthesia group was 3.0 (1.0-3.0).The pain in TIVA groups was significantly lower than that in intravenous-inhalation combined anesthesia group (Z =-3.261,P =0.001).But for 24 hours after operation,the NRS scores in these two groups were 3.0 (2.0-5.0) and 3.0 (3.0-4.0),respectively.There was no significant difference in the two groups (Z =-0.035,P =0.972).In addition,there was no significant difference between the two groups in the incidence of sedation,nausea/vomiting,restlessness and other adverse reactions (all P > 0.05).Long-term follow-up indicated that anesthetic techniques have no correlation with HCC prognosis in Kaplan-Meier analysis and Cox's regression analysis.Conclusion There is no significant effect of two anesthesia methods on the long-term prognosis of HCC.

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