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Effect of regional versus general anaesthesia on postoperative opioid consumption, clinical outcomes and cognitive function in Chinese patients undergoing metastatic cancer surgery

Chunmei Xu
Fang Wang
Jiaojiao Liu
Weiwei Zhan
Changjian Gao


Purpose: To compare postoperative opioid consumption, inflammatory biomarkers, cognitive function and safety profile of regional anesthesia (RA) versus general anesthesia (GA) in Chinese patients undergoing metastatic cancer surgery.
Method: Chinese patients undergoing metastatic cancer surgery were enrolled and received either RA or GA) in allocation ratio of 1:1. The following efficacy variables were assessed: 1) pain score was measured on VAS scale; 2) post-operative consumption; 3) inflammatory biomarkers; 4) cognitive function; 5) clinical outcomes. Safety was also assessed.
Results: Data for a total of 220 patients were analyzed. Compared to GA alone, the combination of RA and GA demonstrated significantly greater reduction in post-operative pain with decreased postoperative opioid consumption. Also, RA/GA combination inhibited inflammatory response when compared to patients who received GA only, indicating that RA + GA improved immune response in patient undergoing surgical intervention. The severity of signs and symptoms of dementia were similar at baseline visit (p > 0.05). Patients of RA/GA group had significantly greater relief in signs and symptoms of dementia/cognitive impairment, when compared to the GA-treated patients (p < 0.05). However, incidence of complications (including adverse events) was comparable for both groups (p > 0.05). Additionally, RA/GA was also associated with shorter length of hospital stay, compared to GA.
Conclusion: RA/GA combination demonstrates significantly greater improvement in the level of clinical outcomes, decreases postoperative opioid consumption, and improves cognitive functions when compared to GA in Chinese patients undergoing metastatic cancer surgery.