Đánh giá hiệu quả giảm đau bằng gây tê ngoài màng cứng trong phẫu thuật nội soi cắt đại, trực tràng

2022 ◽  
Author(s):  
Thanh Xuan Nguyen
Keyword(s):  
Colorectal Cancer ◽  
Side Effects ◽  
Pain Relief ◽  
Visual Analog Scale ◽  
Epidural Anesthesia ◽  
Postoperative Mortality ◽  
Cancer Surgery ◽  
Major Surgery ◽  
Analog Scale ◽  
Colorectal Cancer Surgery

TÓM TẮT Đặt vấn đề: Gây tê ngoài màng cứng để giảm đau trong và sau mổ được áp dụng rộng rãi trên thế giới từ nhiều thập niên qua. Kết quả của nhiều công trình nghiên cứu cho thấy phương pháp này làm giảm những biến chứng trong và sau mổ, giảm tỉ lệ tử vong sau mổ của các phẫu thuật nặng. Nghiên cứu nhằm đánh giá hiệu quả và các tác dụng phụ của gây tê ngoài màng cứng trong phẫu thuật ung thư đại, trực tràng. Phương pháp: Nghiên cứu mô tả cắt ngang trên 28 bệnh nhân được gây tê ngoài màng cứng trong mổ ung thư đại, trực tràng có phối hợp gây mê nội khí quản. Sinh hiệu và tình trạng sức khỏe của bệnh nhân được theo dõi trước và sau khi tiêm thuốc giảm đau. Ghi nhận mức độ giảm đau theo Visual Analog Scale (VAS), mức độ liệt vận động theo Bromage và các tác dụng phụ sau mổ. Kết quả: Hiệu quả giảm đau sau mổ tốt, tại các thời điểm sau mổ VAS đều ≤ 1,5. Tỉ lệ các biến chứng: tụt huyết áp: 7,14%, đau đầu: 7,14%, lạnh run: 10,71%, buồn nôn, nôn: 17,86%. Kết luận: Kỹ thuật gây tê ngoài màng cứng phối hợp với gây mê toàn thân là kỹ thuật giảm đau hiệu quả và an toàn cho phẫu thuật vùng bụng trong mổ và 24 giờ sau mổ. ABSTRACT THE EFFICIENCY OF SPINAL EPIDURAL ANESTHESIA FOR LAPAROSCOPIC COLORECTAL CANCER SURGERY Background: Epidural anesthesia for pain relief during and after surgery has been widely applied in the world for decades. The results of many studies show that this method reduces intra - and postoperative complications and reduces the postoperative mortality rate of major surgery. The study aimed to evaluate epidural anesthesia’s effectiveness and side effects in colorectal cancer surgery. Methods: A cross - sectional descriptive study on 28 patients receiving epidural anesthesia in surgery for colorectal cancer in combination with endotracheal anesthesia. The patient’s vital signs and health status were monitored before and after the injection of pain medication. Record the level of pain relief according to the Visual Analog Scale (VAS), the degree of motor paralysis according to Bromage, and the side effects after surgery. Results: Good postoperative pain relief effect, at all times after surgery, VAS was ≤ 1.5. Rate of complications: hypotension: 7.14%, headache: 7.14%, shiver: 10.71%, nausea, vomiting: 17.86%. Conclusion: The epidural anesthesia combined with general anesthesia is an effective and safe analgesia technique for abdominal surgery during surgery and 24 hours after surgery. Keywords: Epidural anesthesia, colorectal cancersurgery

Ranking and Rankability of Hospital Postoperative Mortality Rates in Colorectal Cancer Surgery

2014 ◽  
Vol 259 (5) ◽  
pp. 844-849 ◽  
Author(s):  
Daniel Henneman ◽  
Annelotte C. M. van Bommel ◽  
Alexander Snijders ◽  
Heleen S. Snijders ◽  
Rob A. E. M. Tollenaar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Mortality ◽  
Mortality Rates ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery

scholarly journals Thirty-day postoperative mortality after colorectal cancer surgery in England

Gut ◽  
2011 ◽  
Vol 60 (6) ◽  
pp. 806-813 ◽  
Author(s):  
E. J. A. Morris ◽  
E. F. Taylor ◽  
J. D. Thomas ◽  
P. Quirke ◽  
P. J. Finan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Mortality ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery

scholarly journals Differences in colorectal cancer surgery outcomes in Serbia: Hospitals in organized colorectal cancer screening and other hospitals

2021 ◽  
Vol 18 (1) ◽  
pp. 8-13
Author(s):  
Dušica Banković-Lazarević ◽  
Verica Jovanović ◽  
Biljana Mijović ◽  
Jelena Brcanski ◽  
Marina Jelić ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Postoperative Mortality ◽  
Cancer Surgery ◽  
Target Group ◽  
Colorectal Cancer Surgery ◽  
Significant Difference ◽  
The Right

Objective. The aim of this study was to compare mortality of patients after colorectal cancer surgery between hospitals in Serbia, which performed organized colorectal cancer screening and those which did not. Methods. The database included all patients who underwent surgery for colorectal cancer after the introduction of organized colorectal cancer screening Program in Serbia, in 2014-2015. The target group were patients 50-74 years old in the colorectal screening program, and the data was compared to the age-matched group from hospitals which did not perform the program logistic regression. Results. The was used to determine the significance of the differences in the observed variables, and the predictors of mortality after colorectal cancer surgery. Results. The 3631 patients were included in this study. The majority of them were operated due to the rectal cancer 2111 (58%), while 1062 (29.2%) were operated due to the colon cancer. Postoperative survival was significantly better in the target group in organized screening program (p<0.001; OR=0.46; 95%CI 0.33-0.62). There was a significant difference between patients who underwent surgery for colorectal cancer localized in the left colon, compared to the patients with localization in the right colon (p<0.001). The mortality after the surgery of colorectal cancer (4.7%) was followed by high comorbidity of cardiovascular diseases (24%). Conclusion. Patients included in the organized colorectal cancer screening have lower postoperative mortality than these not included. This indicates the necessity for further work on organized colorectal cancer screening, in order to reduce postoperative and overall mortality.

scholarly journals Does epidural anesthesia and analgesia really improves surgical outcome after colorectal cancer surgery

2006 ◽  
Vol 53 (2) ◽  
pp. 85-89 ◽  
Author(s):  
K. Rimaitis ◽  
D. Pavalkis
Keyword(s):  
Colorectal Cancer ◽  
Epidural Anesthesia ◽  
Surgical Outcome ◽  
Randomized Clinical Trials ◽  
Colorectal Anastomosis ◽  
Cancer Surgery ◽  
Surgical Trauma ◽  
Colorectal Cancer Surgery ◽  
Beneficial Effects ◽  
Postoperative Epidural Analgesia

Lithuanian Cancer Register has registered 1443 new cases of colorectal cancer in 2004 and this value constantly increases about 200 cases per year 1. Colorectal cancer is on the third place among all cancer patients in our country. Colorectal cancer surgery is associated with a major surgical trauma. Majority of recent randomized clinical trials (RCT) has shown that combined general - epidural anesthesia and postoperative epidural analgesia has demonstrated some beneficial effects and improved surgical outcome in various fields of surgery 2-4. However controversies still exist about epidural anesthesia and analgesia effects on colorectal anastomosis and it?s influence on patients? outcome.

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