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• W4376637324 abstract "Abstract BACKGROUND Patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) constitute two major advances in pain management after major abdominal surgery. However, the effect of PCIA or PCEA has not been particularly studied in elderly patients with gastric cancer. AIM To compare the effect of PCIA to that of PCEA on short-term outcomes in elderly patients undergoing laparoscopic gastrectomy. METHODS This single-center, retrospective study included 254 elderly patients (≥ 70 years) who underwent laparoscopic radical gastrectomy for gastric cancer. Patients received either general anesthesia combined with epidural anesthesia followed by PCEA (PCEA group, n = 123) or general anesthesia alone followed by PCIA (PCIA group, n = 131). The primary endpoint was pain intensity tested using a 100-mm visual analog scale (VAS) on postoperative days 1, 2, and 3. Demographics, comorbidities, perioperative data, postoperative short-term outcomes, and analgesia-related side effects were also assessed. RESULTS The VAS scores at rest were lower in the PCEA group compared to the PCIA group on postoperative day 1, 2, and 3 (27.8 ± 13.9 vs 33.1 ± 15.0, P = 0.004; 25.2 ± 11.3 vs 30.1 ± 14.3, P = 0.002; 16.9 ± 7.1 vs 20.9 ± 9.5, P < 0.001; respectively). The postoperative hospital stay was shorter in the PCEA group than in the PCIV group (11 vs 12 days, P = 0.018). The times to postoperative first flatus, semifluid diet, full ambulation, and tracheal extubation after surgery in the PCEA group were significantly shorter than in the PCIA group. Overall morbidity, mortality, hospital readmission rate, and reoperation rate were not significantly different between the two groups. Regarding side-effects related to analgesia, there were no significant differences in terms of the rates of postoperative nausea and vomiting, urinary retention, or oxygen saturation < 90% between the two groups. However, PCEA was associated with a higher incidence of postoperative hypotension compared to PCIA (10.6% vs 3.8%, P = 0.036). CONCLUSIONS In elderly patients undergoing laparoscopic radical gastrectomy, epidural anesthesia and analgesia may convey superior pain relief, faster restoration of gastrointestinal motility, and shorter hospitalization." @default.
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• W4376637324 date "2023-05-16" @default.
• W4376637324 modified "2023-10-17" @default.
• W4376637324 title "Effects of General Anesthesia Combined with Epidural Anesthesia and Analgesia on Postoperative Short-term Outcomes after Laparoscopic Gastrectomy in Elderly Patients with Gastric Cancer" @default.
• W4376637324 doi "https://doi.org/10.21203/rs.3.rs-2898646/v1" @default.
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