Effects Of Anesthesiaand Analgesia On Postoperative Survival Time Of Ovarian Cancer

Objective: To explore the relationship between the choice of different anesthesia and analgesia methods and postoperative survival time of ovarian cancer patients,and to provide a theoretical basis for the selection of a particular anesthesia and analgesia method in the later stages of ovarian cancer.Methods: Clinical and follow-up data from 976 patients who underwent ovarian tumor cell reduction from January 2006 to December2010,in our hospital,were retrospectively analyzed.903 patients had complete data.A COX regression analysis was performed on factors that might affect the postoperative survival rate.The survival rates from three different anesthesia and analgesia methods,Group A(general anesthesia+intravenous analgesia),Group B(combined spinal-epidural anesthesia+epidural analgesia)and group C(general anesthesia combined with epidural anesthesia+epidural analgesia)were compared and analyzed.Results: 471 patients underwent surgery with general anesthesia+intravenous analgesia,264 patients underwent surgery with combined spinal-epidural anesthesia+epidural analgesia,and 168 patients underwent surgery with general anesthesia combined with epidural anesthesia+epidural analgesia.The anesthesia and analgesia methods,lymph node metastasis,ASA score,preoperative CA125 level and FIGO staging were independent risk factors for postoperative survival time of ovarian cancer.The average survival time in Group A was 46 months(95%CI 44.2-47.8),the average survival time in Group B was 49.9months(95%CI 48.0-51.9),and the average survival time in Group C was48 months(95%CI 45.2-50.8).The average 1,3 and 5-year survival rates for patients in Group A were,95.3%,66.7%,and 53.5% respectively.The average survival rates for 1,3 and 5 years in Group B were 98.1%,76.5%,and 66.3%,respectively.Patients in Group C had an average 1,3 and5-year survival rates of 92.3%,73.2%,and 65.5% respectively.Compared to the group A,the risk factor of postoperative survival rate of group B was 1.103,but without statistical significance(95%CI 0.794-1.533,P=0.599),Compared to the group A,the risk factor of postoperative survival rate of group C was 0.599,with statistical significance(95%CI0.419-0.855,P=0.005).Conclusion: Anesthesia and Analgesia methods are significantly associated with postoperative survival time in ovarian carcinoma patients.Compared with the method of general anesthesia + intravenous analgesia,the method of general anesthesia combined with epidural anesthesia +epidural analgesia have smaller influences on postoperative survival time of patients with ovarian carcinoma,which are more suitable for perioperative anesthesia and analgesia for patients with ovarian carcinoma.