The comparison of two methods of perioperative analgesia insurgical treatments patients with colorectal cancer

Abstract

The goal of the study. To study the efficacy and safety of some methods of anesthesia in the perioperative period in the surgical treatment of colorectal cancer.Materials and methods. The study was performed in the department of Anesthesiology and Intensive Care Unit of the National Cancer Institute in Kiev during the period 03.01.2014 –01.03.2015, prospectively patients were randomized into two groups. In group A (n = 21), patients had the combined inhalation anesthesia with sevoflurane 0.5–0.6 M A C/fentany l 3–4 m c g/kg and epidural anesthesia with ropivacaine 0.2% –8 ml in combination with fentanyl 100 mcg before surgery, muscle relaxation with atracurium. Group B (n = 20) received as anesthetic propofol 4–6 mg/kg/hour and fentanyl 5 mcg/kg, muscle relaxation with atracurium. Postoperatively, group A received patient-controlled epidural analgesia with ropivacaine 0,2% combined with fentanyl 2 mcg/ml, adrenaline 20 mcg/mL and 50 mg parenteral dexketoprofen and paracetam ol. Group B received 10 mg omnopon parenterally. Standard hemodynamic monitoring intra – and postoperative, glucose level swere studied before surgery, after 3 and 10 hours. The quality of postoperative analgesia was ass essed by VAS.Results. The need for fentanyl and musclerelaxants were lessin Gr.A compared with Gr.B, although not statistically significant difference was obtained (p = 0,0561 an d p = 0,1 037 ). Reducing of mean blood pressure in both groups after tracheal intubation was short, no more than 20 – 25% from baseline and resumed for 10–20 minutes. In Gr.A in all phases of the study blood glucose levels remained stable and did not go beyond the norm, while in Gr.B the blood sugar level was increased up to 50% compared with values preoperative figures. Only 10 day safter surgery, blood glucose levels decreased to preoperating values. The level of postoperative pain on VAS was greater in Gr.B during the observation period, compared with Gr. A.Conclusions. Combined inhalation anesthesia with sevoflurane/fentanyl and epidural anesthesia with ropivacaine inlow concentration in a mixture of fentanyl and postoperative patient-controlled epidural analgesia with ropivacaine combined with fentanyl, adrenaline and parenteral dexketoprofen and paracetamol are effective and safe methods of analgesia in the perioperative period in patients under going cancer surgery.