Anesthetic Quality of Epidural Anesthesia with General Anesthesia Applied for Surgery of Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 TAN Xingzhong ¹ , YUE Yongmeng ¹ , WANG Xiaodong ²

1.Department of Anesthesiology， Central Hospital of Bazhong City， Bazhong 636000， Sichuan Province， China;;
2.Center of Gastrointestinal Surgery， West China Hospital， Sichuan University， Chengdu 610041， Sichuan Province， China;

Corresponding author：

TAN Xingzhong, Email: 1501079468@qq.com

Keywords：

Epidural anesthesia; General anesthesia; Rectal cancer; Anesthetic quality; Anesthetic adverse reaction

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To explore anesthetic quality of epidural anesthesia with general anesthesia applied for surgery of rectal cancer.
Methods 　One hundred and seventy-eight patients who were diagnosed as rectal cancer and received operation in the Central Hospital of Bazhong City from June 2010 to June 2012 were included retrospectively. These patients were divided into two groups according to the type of anesthesia， and the patients who received general anesthesia only were defined as group A， the patients who received epidural anesthesia with general anesthesia were defined as group B. The anesthetic quality and anesthetic adverse reaction were observed in two groups.
Results 　The differences of baseline characteristics in two groups were not significant （P＞0.05）. The difference of anesthetic quality in two groups was not significant （P＞0.05）. In terms of anesthetic adverse reaction， the incidence rate of hypertension， hypotension，tachycardia， or postoperative nausea and vomiting of the group B was significantly lower than those of the group A （P＜0.05）. The incidence rate of bradycardia， premature ventricular contractions， or time of gastrointestinal function recovery had no significant differences （P＞0.05）. There was no nerve dysfunction of lower limb in two groups.
Conclusion　 Epidural anesthesia with general anesthesia applied for surgery of rectal cancer as compared with general anesthesia only not only has the same anesthetic quality， but also has obvious advantages in decreasing anesthetic adverse reaction.

Citation： TAN Xingzhong,YUE Yongmeng,WANG Xiaodong. Anesthetic Quality of Epidural Anesthesia with General Anesthesia Applied for Surgery of Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(8): 905-909. doi: Copy

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10.	Tsui BC， Rashiq S， Schopflocher D， et al. Epidural anesthesia and cancer recurrence rates after radical prostatectomy[J]. Can J Anaesth， 2010， 57(2)：107-112.
11.	Holte K， Foss NB， Svensén C， et al. Epidural anesthesia， hypotension， and changes in intravascular volume[J]. Anesthesiology， 2004， 100(2)：281-286.
12.	Kehlet H， Dahl JB. Anaesthesia， surgery， and challenges in postoperative recovery[J]. Lancet， 2003， 362(9399)：1921-1928.
13.	Gupta A， Björnsson A， Fredriksson M， et al. Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic cancer surgery：a retrospective analysis of data from 655 patients in central Sweden[J]. Br J Anaesth， 2011， 107(2)：164-170.
14.	Sala C， García-Granero E， Molina MJ， et al. Effect of epidural anesthesia on colorectal anastomosis：a tonometric assessment[J]. Dis Colon Rectum， 1997， 40(8)：958-961.
15.	Ricaurte L， Vargas J， Lozano E， et al. Anesthesia and kidney transplantation[J]. Transplant Proc， 2013， 45(4)：1386-1391.
16.	Monaco F， Biselli C， Landoni G， et al. Thoracic epidural anesth-esia improves early outcome in patients undergoing cardiac surgeryfor mitral regurgitation：a propensity-matched study[J]. J Cardio-thorac Vasc Anesth， 2013， 27(3)：445-450.
17.	Tzimas P， Prout J， Papadopoulos G， et al. Epidural anaesthesia and analgesia for liver resection[J]. Anaesthesia， 2013， 68(6)：628-635.
18.	Binczak M， Tournay E， Billard V， et al. Major abdominal surgeryfor cancer：Does epidural analgesia have a long-term effect on recurrence-free and overall survival?[J]. Ann Fr Anesth Reanim，.
19.	Okutani H， Okutani R， Nakamura T. Asystole developed during total gastrectomy under general anesthesia combined with thoracic epidural anesthesia[J]. Osaka City Med J， 2012， 58(2)：83-86.
20.	Panaretou V， Siafaka I， Theodorou D， et al. Combined general-epidural anesthesia with continuous postoperative epidural analgesiapreserves sigmoid colon perfusion in elective infrarenal aorticaneurysm repair[J]. Saudi J Anaesth， 2012， 6(4)：373-379.
21.	Claeys MA， Gepts E， Camu F. Haemodynamic changes duringanaesthesia induced and maintained with propofol[J]. Br J Anaesth， 1988， 60(1)：3-9.
22.	Naito Y， Tamai S， Shingu K， et al. Responses of plasma adrenocorticotropic hormone， cortisol， and cytokines during and after upper abdominal surgery[J]. Anesthesiology， 1992， 77(3)：426-431.
23.	Adams MC， Fifer MA， Jiang Y. New-onset left bundle branch block immediately following noncardiac surgery under combined general and epidural anesthesia[J]. J Anesth， 2013， 12(5)：11-26.
24.	Ezhevskaya AA， Mlyavykh SG， Anderson DG. The effects of continuous epidural anesthesia and postoperative epidural analgesiaon pain management and stress response in patients undergoing major spinal surgery[J]. Spine (Phila Pa 1976)， 2013， 41(8)：351-369.
25.	， 32(5)：e81-e88.

1. Arain MR， Buggy DJ. Anaesthesia for cancer patients[J]. Curr Opin Anaesthesiol， 2007， 20(3)：247-253.
2. Gottschalk A， Ford JG， Regelin CC， et al. Association between epidural analgesia and cancer recurrence after colorectal cancer surgery[J]. Anesthesiology， 2010， 113(1)：27-34.
3. Ahlers O， Nachtigall I， Lenze J， et al. Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery[J]. Br J Anaesth， 2008， 101(6)：781-787.
4. 刘展，汪晓东，李立. 结直肠外科快速流程内容及依据[J]. 中国普外基础与临床杂志， 2007， 14(4)：469-473.
5. Wilmore DW， Kehlet H. Management of patients in fast track surgery[J]. BMJ， 2001， 322(7284)：473-476.
6. 李立，汪晓东，舒晔，等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(一)[J]. 中国普外基础与临床杂志， 2009， 16(5)：413.
7. Kremer M， Ulrich A， Büchler MW， et al. Fast-track surgery：the Heidelberg experience[J]. Recent Results Cancer Res， 2005， 165：14-20.
8. Langelotz C， Spies C， Müller JM， et al. “Fast-track”-rehabilitation in surgery， a multimodal concept[J]. Acta Chir Belg， 2005， 105(6)：555-559.
9. Gouvas N， Gogos-Pappas G， Tsimogiannis K， et al. Implementation of fast-track protocols in open and laparoscopic sphincter-preserving rectal cancer surgery：a multicenter， comparative， prospective， non-randomized study[J]. Dig Surg， 2012， 29(4)：301-309.
10. Tsui BC， Rashiq S， Schopflocher D， et al. Epidural anesthesia and cancer recurrence rates after radical prostatectomy[J]. Can J Anaesth， 2010， 57(2)：107-112.
11. Holte K， Foss NB， Svensén C， et al. Epidural anesthesia， hypotension， and changes in intravascular volume[J]. Anesthesiology， 2004， 100(2)：281-286.
12. Kehlet H， Dahl JB. Anaesthesia， surgery， and challenges in postoperative recovery[J]. Lancet， 2003， 362(9399)：1921-1928.
13. Gupta A， Björnsson A， Fredriksson M， et al. Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic cancer surgery：a retrospective analysis of data from 655 patients in central Sweden[J]. Br J Anaesth， 2011， 107(2)：164-170.
14. Sala C， García-Granero E， Molina MJ， et al. Effect of epidural anesthesia on colorectal anastomosis：a tonometric assessment[J]. Dis Colon Rectum， 1997， 40(8)：958-961.
15. Ricaurte L， Vargas J， Lozano E， et al. Anesthesia and kidney transplantation[J]. Transplant Proc， 2013， 45(4)：1386-1391.
16. Monaco F， Biselli C， Landoni G， et al. Thoracic epidural anesth-esia improves early outcome in patients undergoing cardiac surgeryfor mitral regurgitation：a propensity-matched study[J]. J Cardio-thorac Vasc Anesth， 2013， 27(3)：445-450.
17. Tzimas P， Prout J， Papadopoulos G， et al. Epidural anaesthesia and analgesia for liver resection[J]. Anaesthesia， 2013， 68(6)：628-635.
18. Binczak M， Tournay E， Billard V， et al. Major abdominal surgeryfor cancer：Does epidural analgesia have a long-term effect on recurrence-free and overall survival?[J]. Ann Fr Anesth Reanim，.
19. Okutani H， Okutani R， Nakamura T. Asystole developed during total gastrectomy under general anesthesia combined with thoracic epidural anesthesia[J]. Osaka City Med J， 2012， 58(2)：83-86.
20. Panaretou V， Siafaka I， Theodorou D， et al. Combined general-epidural anesthesia with continuous postoperative epidural analgesiapreserves sigmoid colon perfusion in elective infrarenal aorticaneurysm repair[J]. Saudi J Anaesth， 2012， 6(4)：373-379.
21. Claeys MA， Gepts E， Camu F. Haemodynamic changes duringanaesthesia induced and maintained with propofol[J]. Br J Anaesth， 1988， 60(1)：3-9.
22. Naito Y， Tamai S， Shingu K， et al. Responses of plasma adrenocorticotropic hormone， cortisol， and cytokines during and after upper abdominal surgery[J]. Anesthesiology， 1992， 77(3)：426-431.
23. Adams MC， Fifer MA， Jiang Y. New-onset left bundle branch block immediately following noncardiac surgery under combined general and epidural anesthesia[J]. J Anesth， 2013， 12(5)：11-26.
24. Ezhevskaya AA， Mlyavykh SG， Anderson DG. The effects of continuous epidural anesthesia and postoperative epidural analgesiaon pain management and stress response in patients undergoing major spinal surgery[J]. Spine (Phila Pa 1976)， 2013， 41(8)：351-369.
25. ， 32(5)：e81-e88.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Anesthetic Quality of Epidural Anesthesia with General Anesthesia Applied for Surgery of Rectal Cancer

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