Effects of different ways of anesthesia on the prognosis of geriatric patients of pheochromocytoma / 临床麻醉学杂志

ABSTRACT

Objective The purpose of our study is to analyze the effects of different ways of anesthesia on the prognosis of these patients.Methods Our study was a retrospective study,enrolling elderly patients (≥65 years)undergoing pheochromocytoma resection surgery from Jan 2004 to Feb 201 5 in our hospital.We recorded perioperative data including demography,primary disease,com-bined disease,preoperative management,anesthesiology,surgery,and prognosis.Then we divided the patients into two groups,general anesthesia (group G)and general anesthesia combined with epi-dural anesthesia (group GE),to make further statistical analysis.Results There were 33 patients en-rolled,totally undergoing 35 cases of surgery accounting for 13.4% of pheochromocytoma resection surgery in the same period in our hospital.The maintenance of analgesia during surgery by using remifentanyl (18.2% vs 79.2%,P = 0.001 )and sufentanyl (45.5% vs 79.2%,P = 0.046 )were significantly lower in group of general anesthesia combined with epidural anesthesia.However hemo-dynamic parameters didn’t show statistical difference between groups.There were no patients dead during perioperative period.In group GE,the duration of mechanical ventilation (P =0.039),post-operative hospital stay (P =0.013)and total hospital stay (P =0.01 5)were much shorter than those in group G.Multivariable Cox model analysis showed that general anesthesia combined with epidural anesthesia was an independent protective factor for shorter postoperative hospital stay (RR=0.245, 95% CI 0.106-0.564,P =0.001),and combination of vasopressors during operation were the inde-pendent predictors of longer postoperative hospital stay (RR= 4.184,95% CI 1.146-1 5.281,P =0.030).Conclusion During pheochromocytoma resection surgery in elderly patients,general anesthe-sia combined with epidural anesthesia had lower rate of using intravenous analgesic drugs,shorter du-ration of mechanical ventilation,postoperative hospital stay and total hospital stay.