scholarly journals Radio-frequency thermal ablation of lung cancer under epidural anaesthesia: comparison of the effectiveness of blocks between higher and mid-thoracic level

2009 ◽  
pp. 36-38
Author(s):  
MR Khandoker ◽  
H Razwanul ◽  
H Rashadul ◽  
AM Sarwar ◽  
UH Shahera Khatun
Keyword(s):  
Lung Cancer ◽  
Thermal Ablation ◽  
Heat Rate ◽  
Epidural Block ◽  
Epidural Needle ◽  
Epidural Group ◽  
Lung Cancer Patients ◽  
Thoracic Epidural ◽  
Group A ◽  
Group B

Purpose of the investigation is to evaluate the effectiveness of high thoracic epidural block in comparison to mid-thoracic epidural during Radiofrequency ablation for lung cancer. 60 patients (38 male) were selected for epidural segmental block who were proposed for radiofrequency thermal ablation for lung cancer. Patients were randomly divided in 2 groups: Group-A, higher thoracic epidural group & Group-B, mid-thoracic epidural group. Under all aseptic preparation 18 G Epidural catheter was inserted through 18 G epidural needle and 4-6 ml of 0.5% bupivacaine was used during anaesthesia. Extend of block was demarcated by pain prick. RFT probe was allowed to insert 30 minutes after anaesthesia. The heat rate, blood pressure, respiration, Sp02 and temperature were monitored continuously during the procedure. Excellent block was found in 21 cases of Group-A and 15 cases of Group-B. Anaesthesia was inadequate in two cases of Group-A, and in 5 cases of Group-B, So, Higher thoracic epidural technique is better than mid thoracic epidural.DOI: http://dx.doi.org/10.3329/jbsa.v17i1.4050 Journal of BSA, Vol. 17, No. 1 & 2, 2004 p.36-38

Observation of clinical efficacy and survival of lung cancer patients with UMIPIC combined with low-dose chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21605-e21605
Author(s):  
Jianbin Feng ◽  
Peng Jing ◽  
Feng Gao ◽  
Jian Liu ◽  
Wei Han ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Time ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Low Dose ◽  
Survival Rates ◽  
Lung Cancer Patients ◽  
Group A ◽  
Group B ◽  
Low Dose Chemotherapy

e21605 Background: To observe the clinical efficacy and survival of UMIPIC combined with low-dose chemotherapy in patients with lung cancer. Methods: 840 patients with lung cancer underwent UMIPIC treatment from January 2011 to December 2015 were selected as the study subjects, 341 cases combined with low-dose chemotherapy in group A and 499 cases not combined with chemotherapy in group B. All patients were diagnosed with lung cancer and signed a consent form for treatment. The patients were treated according to the UMIPIC treatment guidelines. This study was mainly to observe the adverse reactions, clinical efficacy, survival time and survival rate of lung cancer patients after receiving UMIPIC combined with or without low dose chemotherapy. Results: The common adverse reactions in group A were fever 38.12%, followed by pain 9.38%, hemoglobin 7.94%, white blood cells 5.01%, nausea 2.35%, liver function damage 1.19%, vomiting 1.17%, and kidney function damage 0.30%; Common adverse reactions in group B were fever 38.68%, followed by pain 13.23%, hemoglobin reduction 12.87%, white blood cell reduction 5.29%, nausea 2.00%, vomiting 2.00%, liver function damage 1.92%. The hemoglobin reduction in group A was significantly lower than that in group B (P < 0.05), and there was no difference in the other adverse reactions (P > 0.05). Clinical efficacy of the two groups revealed that the benefit rate of group A was 95.45% higher than that of group B 93.47% (P > 0.05). After follow-up, it was found that the average survival time and median survival time of patients in group A were 20.744 and 13.270 months, respectively, which were significantly higher than those of group B at 19.514 and 10.070 months (P < 0.05). The survival rates of the two groups of patients, The 1-year, 2-year, and 5-year survival rates of group A patients are 52.48%, 23.60%, and 16.95%, and the 1-year, 2-year, and 5-year survival rates of group B patients are 42.96% and 17.07 % And 10.26%, the one-year survival rate of group A was significantly higher than that of group B (P < 0.05). Conclusions: UMIPIC combined with low-dose chemotherapy has a good clinical effect in treating lung cancer without increasing the incidence of adverse reactions, and a significant effect on extending survival time and improving survival rate of lung cancer patients.

The Effects of Serum hs-CRP on the Incidence of Lung Cancer in Male Patients with Pulmonary Tuberculosis

2020 ◽  
Author(s):  
Youhua JIANG ◽  
Kewei NI ◽  
Meiyu FANG ◽  
Junling LIU
Keyword(s):  
Lung Cancer ◽  
Pulmonary Tuberculosis ◽  
Cancer Patients ◽  
Serum Levels ◽  
Incidence Rates ◽  
Lung Cancer Patients ◽  
Group A ◽  
Male Patients ◽  
Hs Crp ◽  
Group B

Background: This study intended to investigate the effects of serum high-sensitivity C-reactive protein (hs-CRP) on the incidence of lung cancer in male patients with pulmonary tuberculosis. Methods: A total of 1091 male patients with pulmonary tuberculosis in Zhejiang Cancer Hospital, Hangzhou, China from Jan 2009 to Jan 2012 were selected as the research objects. All patients were followed up from the beginning of hospitalization. According to serum hs-CRP level, patients were divided into two groups: group A (hs-CRP < 1 mg/L) and group B (hs-CRP > 3 mg/L). The relationship between baseline hs-CRP and the risk of lung cancer in patients with pulmonary tuberculosis was analyzed by multivariate Cox proportional risk regression model, and the serum levels of hs-CRP between lung cancer patients in all groups and other non-lung cancer patients were compared. Results: There were differences in age, drinking, smoking, diabetes history, body mass index (BMI), thyroglobulin (TG), history of hypertension and hyperglycemia among the three groups (P=0.036, 0.018, 0.040, 0.029, 0.006, 0.034, 0.020, 0.010). The serum levels of hs-CRP in patients with squamous carcinoma, adenocarcinoma and small cell carcinoma were significantly higher than those in non-lung cancer patients (P=0.022, 0.043, 0.011). The incidence rates of lung cancer in patients in group B and C were 1.37 and 1.69 times higher than that in group A, respectively. Conclusion: The increased serum level of hs-CRP will increase the incidence rate of lung cancer in male patients with pulmonary tuberculosis.

Postoperative radiation for lung cancer metastatic to the brain.

1994 ◽  
Vol 12 (11) ◽  
pp. 2340-2344 ◽  
Author(s):  
J G Armstrong ◽  
M Wronski ◽  
J Galicich ◽  
E Arbit ◽  
S A Leibel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Survival Rates ◽  
Term Survival ◽  
Lung Cancer Patients ◽  
C 23 ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
The Brain

PURPOSE Although resection of single brain metastases and postoperative whole-brain radiation therapy (WBRT) improves survival, compared with treatment using WBRT alone, the value of postoperative WBRT after resection of brain metastases is controversial. We analyzed the largest reported series of lung cancer patients with resected brain metastases to evaluate the impact of postoperative WBRT. MATERIALS AND METHODS Between 1974 and 1989, 185 patients with non-small-cell lung cancer (NSCLC) underwent resection of brain metastases. Patients who had received preoperative WBRT (23%, 42 of 185) were excluded. The remaining patients were divided into group A (no WBRT; n = 32), group B (patients received WBRT and were prognostically matched to group A; n = 32), and group C (all other WBRT patients; n = 79). Most patients received postoperative doses of 30 Gy in 10 fractions. Higher doses were used in 16% of group B and 18% of group C patients. RESULTS Overall 5-year survival rates were as follows: group A, 12%; B, 8%; C, 16%. Overall brain failures occurred in 38% of patients in group A, 47% in group B, and 42% in group C. The use of WBRT (group A v groups B plus C) had no apparent impact on survival or on overall brain failure rates. In particular, no improvement in either of these parameters could be demonstrated when group B was compared with group A. Focal failure (defined as failure within the brain adjacent to the site of the resected brain metastases) occurred as follows: group A, 34% (11 of 32); groups B plus C, 23% (25 of 111) (P = .07). WBRT significantly reduced focal failure for patients with adenocarcinoma (group A, 33% [eight of 24]; groups B plus C, 14% [11 of 79]; P = .05). Nonfocal failure (anatomically distinct from the resected metastasis) occurred in 9% of patients in group A (three of 32), 21% in groups B plus C (23 of 111) (P = .07). CONCLUSION Long-term survival is possible when NSCLC brain metastases are resected. Postoperative WBRT as used in this series only had an impact on the focal control of brain metastases and this effect was of borderline significance. The lack of conclusive benefit supports the need for ongoing randomized trials to test the value of adjuvant postoperative WBRT. Brain failures were relatively common in all three groups of patients, which suggests that doses greater than 30 Gy need to be studied.

scholarly journals Effect of Eye Movement Training on Sleep Quality of Patients with Advanced Lung Cancer Based on Pittsburgh Sleep Quality Index

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Haiping Hu ◽  
Wenying Yang ◽  
Zhimin Liu ◽  
Xiaona Zhang ◽  
Junmei Shi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sleep Quality ◽  
Eye Movement ◽  
Negative Emotion ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Movement Training ◽  
Pain Scores ◽  
Group A ◽  
Group B

Objective. To explore the effect of eye movement training on sleep quality of patients with advanced lung cancer based on the Pittsburgh Sleep Quality Index (PSQI). Methods. 120 advanced lung cancer patients admitted to our hospital from January 2019 to January 2020 were selected as the research object and divided into group A (PSQI scores ≥ 10 points, n = 60) and group B (PSQI < 10 points, n = 60). Routine nursing was performed to both groups, and patients in group A received the eye movement training additionally, so as to compare their PSQI scores, negative emotion scores, adverse reaction rate (ARR), Cancer Coping Modes Questionnaire (CCMQ) scores, and pain scores. Results. After training, group A obtained significantly better sleep quality ( P < 0.05 ), lower negative emotion scores ( P < 0.001 ), lower ARR ( P < 0.05 ), better CCMQ scores ( P < 0.05 ), and lower pain scores ( P < 0.001 ) than group B. Conclusion. Eye movement training should be promoted in practice because it can reduce negative emotions, alleviate pain sensation, improve sleep quality and body condition, and lower the ARR for advanced lung cancer patients.

Auricular acupressure for cancer-related fatigue during lung cancer chemotherapy: a randomised trial

2019 ◽  
pp. bmjspcare-2019-001937 ◽  
Author(s):  
Lu Lin ◽  
Yan Zhang ◽  
Hong Ying Qian ◽  
Jia Li Xu ◽  
Cong Yan Xie ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sleep Quality ◽  
Cancer Patients ◽  
Magnetic Beads ◽  
Physical Fatigue ◽  
Lung Cancer Patients ◽  
Cancer Related Fatigue ◽  
Auricular Acupressure ◽  
Group A ◽  
Group B

PurposeTo evaluate the effect of auricular acupressure (AA) on cancer-related fatigue (CRF), sleep disturbance and anxiety in lung cancer patients undergoing chemotherapy.Materials and methodsPatients were recruited from the respiratory department of a general hospital and were randomised into three groups. A 9-week course of AA using Semen Vaccariae (SV) (Group A)/AA using magnetic beads (Group B)/routine care (Group C) was implemented. CRF scores were used as the primary outcome while the sleep and anxiety scores were the secondary outcomes. Analysis of variance and least significant difference t-test were used to determine the intergroup differences and paired-sample t-test was used for the intragroup comparison.Results100 lung cancer patients undergoing chemotherapy were included. Compared with Group C, AA could significantly alleviate CRF (F:24.63, p<0.01), especially for physical and affective fatigue and Group A was more effective for managing physical fatigue than Group B in per-protocol (PP) (−1.75 (−2.69 to –0.82), p<0.01)/Intention to Treat analysis (ITT) (−1.41 (−2.39 to –0.41), p=0.01) analysis. However, AA had no effect on cognitive fatigue. Compared with Group C, only Group A produced significant improvements in sleep quality in PP analysis (−1.17 (−2.23 to –0.10), p=0.03) while it yielded negative results in ITT analysis (−0.82 (−1.74 to 0.10), p=0.08). Compared with Group C, AA could significantly reduce anxiety in PP analysis (F:9.35, p<0.01) while there was no statistical difference between Group B and Group C (−0.95 (−2.81 to 0.90), p=0.31), Group A and Group B (−1.26 (−3.12 to 0.59), p=0.18) in ITT analysis.ConclusionAA can alleviate CRF of lung cancer patients undergoing chemotherapy, especially for physical and affective fatigue. AA using SV is more effective for physical fatigue while AA using magnetic beads works better for anxiety. However, AA cannot improve the sleep quality.Trial registration numberISRCTNregistry (ISRCTN16408424).

scholarly journals Survival Impact of Aggressive Treatment and PD-L1 Expression in Oligometastatic NSCLC

2021 ◽  
Vol 28 (1) ◽  
pp. 593-605
Author(s):  
Camille Gauvin ◽  
Vimal Krishnan ◽  
Imane Kaci ◽  
Danh Tran-Thanh ◽  
Karine Bédard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cell Death ◽  
Treatment Group ◽  
Programmed Cell Death ◽  
Prognostic Impact ◽  
Aggressive Treatment ◽  
Palliative Approach ◽  
Oligometastatic Disease ◽  
Group A ◽  
Group B

Background: Studies have shown that aggressive treatment of non-small cell lung cancer (NSCLC) with oligometastatic disease improves the overall survival (OS) compared to a palliative approach and some immunotherapy checkpoint inhibitors, such as anti-programmed cell death ligand 1 (PD-L1), anti-programmed cell death protein 1 (PD-1), and T-Lymphocyte-associated antigen 4 (CTLA-4) inhibitors are now part of the standard of care for advanced NSCLC. However, the prognostic impact of PD-L1 expression in the oligometastatic setting remains unknown. Methods: Patients with oligometastatic NSCLC were identified from the patient database of the Centre hospitalier de l’Université de Montréal (CHUM). “Oligometastatic disease” definition chosen is one synchronous metastasis based on the M1b staging of the eight IASLC (The International Association for the Study of Lung Cancer) Classification (within sixth months of diagnosis) or up to three cerebral metastasis based on the methodology of the previous major phase II randomized study of Gomez et al. We compared the OS between patients receiving aggressive treatment at both metastatic and primary sites (Group A) and patients receiving non-aggressive treatment (Group B). Subgroup analysis was performed using tumor PD-L1 expression. Results: Among 643 metastatic NSCLC patients, we identified 67 patients with oligometastasis (10%). Median follow-up was 13.3 months. Twenty-nine patients (43%) received radical treatment at metastatic and primary sites (Group A), and 38 patients (57%) received non-aggressive treatment (Group B). The median OS (mOS) of Group A was significantly longer than for Group B (26 months vs. 5 months, p = 0.0001). Median progression-free survival (mPFS) of Group A was superior than Group B (17.5 months vs. 3.4 months, p = 0.0001). This difference was still significant when controlled for primary tumor staging: stage I (p = 0.316), stage II (p = 0.024), and stage III (p = 0.001). In the cohort of patients who were not treated with PD-L1 inhibitors, PD-L1 expression negatively correlated with mOS. Conclusions: Aggressive treatments of oligometastatic NSCLC significantly improve mOS and mPFS compared to a more palliative approach. PD-L1 expression is a negative prognostic factor which suggests a possible role for immunotherapy in this setting.

scholarly journals Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

2017 ◽  
Vol 6 (7) ◽  
pp. 2836
Author(s):  
Ashima Taneja ◽  
Kamaldeep Arora ◽  
Isha Chopra ◽  
Anju Grewal ◽  
Sushree Samiksha Naik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Epidural Analgesia ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Epidural Group ◽  
Patient Satisfaction Score ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group.

scholarly journals Combined spinal epidural anaesthesia versus epidural anaesthesia: a comparative study

2020 ◽  
Vol 10 (2) ◽  
pp. 36-39
Author(s):  
Pramesh Sunder Shrestha ◽  
Ninadini Shrestha ◽  
Anil Shrestha ◽  
Roshana Amatya ◽  
Bigen Man Shakya ◽  
...  
Keyword(s):  
Comparative Study ◽  
Epidural Anaesthesia ◽  
Epidural Block ◽  
Spinal Block ◽  
Epidural Group ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Cross Sectional ◽  
Group B ◽  
Spinal Epidural

Background: Regional anaesthesia are widely utilized in surgical gynaecology practice. The Com­bined Spinal Epidural Anaesthesia (CSEA) technique and Continuous epidural anaesthesia both have been extensively used in elective gynaecological surgeries. This prospective cross-sectional comparative study was designed to compare the quality of anaesthesia between CSEA and Epi­dural anaesthesia. Methods: Sixty-four patients between age group 15- 65 years of ASA grade I, II were randomly di­vided into 2 groups. Group A patients received CSEA using “double needle double interspace tech­nique” and were given 2.5 ml of 0.5% hyperbaric bupivacaine for spinal block. Group B patients received epidural block with catheter using 10 ml of 0.5% plain bupivacaine. In all patients, subse­quent dosage of 2 ml per unblocked segment 0.5% plain bupivacaine was administered through the epidural catheter to achieve a block up to T4-5. Mean was calculated using t-test, median with Mann Whitney U test and Chi-square test where appropriate and the Statistical Analysis was done using SPSS program, version 11.0. Results: The surgical anaesthesia and motor blockade occurred significantly early in CSEA group. Duration of analgesia was significantly shorter in CSEA (84.1±40.6 min) as compared to epidural group (138.6±32.9 min). The total amount of bupivacaine required to attain the same target level was two times in epidural group (p<0.05). Haemodynamic changes were comparable in both the groups. No neurological side effects were observed. Conclusions: Sequential CSEA is superior alternative to epidural block, which combines the advan­tages of spinal and epidural while minimizing their drawbacks in elective gynaecological surgeries.

scholarly journals Diagnostic Value of Imaging Combined With Tumor Markers in Early Detection of Lung Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Su-Ju Wei ◽  
Li-Ping Wang ◽  
Jun-Yan Wang ◽  
Jing-Xu Ma ◽  
Feng-Bin Chuan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Detection ◽  
Tumor Markers ◽  
Cancer Diagnosis ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Lung Cancer Diagnosis ◽  
Early Lung Cancer ◽  
Group A ◽  
Group B

Objective: The objective of this research is to explore the diagnostic value of imaging plus tumor markers in the early detection of lung cancer.Methods: Sixty patients with lung cancer treated in our hospital from January 2018 to January 2019 were selected as group A. They were matched with 60 patients with benign lung disease as group B and 60 healthy subjects examined in our hospital as group C. The carcino-embryonic antigen (CEA), CYFRA21-1, and neuron-specific enolase (NSE) were assessed, and the diagnostic value of tumor markers plus imaging in lung cancer diagnosis was explored.Results: The CEA, CYFRA21-1, and NSE in group A were evidently superior to those in groups B and C, and those in group B were superior to those in group C (all P &lt; 0.001). CEA had the highest sensitivity (56.7%), and NSE had the highest specificity (93.3%). The tumor markers plus imaging had the highest sensitivity for different types of lung cancer, and the sensitivity to early lung cancer (90%) was superior to other diagnostic methods (P &lt; 0.05).Conclusion: The tumor markers plus imaging is of great significance in early lung cancer diagnosis and provides a reference for judging the pathological classification.

Thoracic Epidural Anesthesia for Coronary Bypass Surgery Affects Autonomic Neural Function and Arrhythmias

2005 ◽  
Vol 1 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Noriyoshi Yashiki ◽  
Go Watanabe ◽  
Shigeyuki Tomita ◽  
Satoru Nishida ◽  
Tamotsu Yasuda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
General Anesthesia ◽  
Sympathetic Activity ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Thoracic Epidural ◽  
Group A ◽  
Group B

Background In recent years, the invasiveness of coronary reconstruction has been markedly reduced. Awake off-pump coronary artery bypass (AOCAB), coronary bypass surgery with thoracic epidural anesthesia (TEA) without general anesthesia and cardiopulmonary bypass), has been reported in the literature. Because the details of this technique are still unclear, we evaluated its usefulness by examining the autonomic neural state and the incidence of arrhythmia. Methods Fifty-five patients who underwent elective coronary artery bypass grafting (CABG) between April and December 2003 were included in the study. Patients who underwent CABG under high TEA alone comprised group A, those who underwent CABG under general anesthesia combined with TEA comprised group B, and those who underwent CABG under general anesthesia alone comprised group C. Holter electrocardiography was performed before and after surgery, and perioperative electrocardiograms were recorded (before surgery and during surgery, postoperative days 0–3, and postoperative day 7). On obtained electrocardiograms, the autonomic neural state was evaluated by analysis of heart rate variability, and the incidence of atrial fibrillation. Results Concerning the autonomic neural state, sympathetic inhibition was observed during TEA in both groups A and B. After discontinuation of TEA, sympathetic activity recovered. Vagal activity was not inhibited in group A, but decreased during surgery and gradually recovered after surgery in group B. Evaluation of the balance between sympathetic and vagal activities showed that sympathetic activity became predominant rapidly on postoperative day 2 in group B but gradually after surgery in group A. The incidence of postoperative atrial fibrillation was the highest in group B. Conclusions In AOCAB, because there is no vagal inhibition, vagal dominance can be maintained after surgery. This may be associated with the lower incidence of postoperative atrial fibrillation in group A compared with group B. Further studies are necessary to evaluate the details of AOCAB.

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