Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Comparison of efficacy and safety of general anesthesia alone with those of combined epidural/general anesthesia in Chinese patients with gastric cancer undergoing laparoscopy-assisted tumor resection

Hui Liu, Jie Wang, Hui Cao, Chao Zhang, Qingying Ma

Department of Anesthesiology, Suzhou Ninth People's Hospital Soochow University, Suzhou, Jiangsu Province, China;

For correspondence:- Qingying Ma Email: ma987qingying@gmail.com Tel:+8613255195686

Accepted: 23 September 2021 Published: 31 August 2021

Citation: Liu H, Wang J, Cao H, Zhang C, Ma Q. Comparison of efficacy and safety of general anesthesia alone with those of combined epidural/general anesthesia in Chinese patients with gastric cancer undergoing laparoscopy-assisted tumor resection. Trop J Pharm Res 2021; 20(10):2179-2185 doi: 10.4314/tjpr.v20i10.23

© 2021 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To compare postoperative opioid consumption, inflammatory response, survival/clinical outcomes and safety profile of epidural combined with general anesthesia (GA) versus GA in stage 1 gastric cancer patients undergoing surgical intervention by laparoscopy.

Methods: Chinese patients with early?stage gastric cancer undergoing laparoscopic-assisted tumor resection were enrolled and received either epidural combined with general anesthesia (group EA + GA) or general anesthesia only (group GA) in allocation ratio of 1:1. The following efficacy variables were assessed: 1) Pain score was measured on VAS scale; 2) post-operative consumption; 3) Quality of recovery; 4) inflammatory response; and 5) survival outcome. Safety was assessed throughout the study period.

Results: Data for 200 subjects were analyzed. Compared to GA alone, combination of EA + GA demonstrate significantly greater reduction in post-operative pain with decrease postoperative opioid consumption. Also, the combination of GA and EA inhibited inflammatory response when compared to patients who received GA only. Moreover, the combination of GA and EA did not demonstrate any clinical benefit in survival outcome, when compared to patients who received GA alone, indicating that GA + EA has no role in improving survival outcome among patients undergoing gastric cancer surgery. Additionally, EA + GA was also associated with a shorter length of hospital stay, compared to GA.

Conclusion: Overall, the results favor the use of GA + EA in Chinese patients with early?stage gastric cancer undergoing laparoscopic-assisted tumor resection. GA + EA combination improves immune response by inhibiting the inflammatory response but has no significant effect on survival outcome.

Keywords: Inflammatory response, General anesthesia, Epidural anesthesia, Gastric cancer, Survival, Postoperative opioid consumption