Jinekolojik Onkolojik Operasyon Geçiren Hastalarda Epidural Analjezi ile Geleneksel Analjezinin Sağkalım Üzerine Etkileri Karşılaştırılması: Retrospektif Bir Analiz

Year 2024, , 111 - 118, 06.11.2024

Nevin Aydın , Nevin Tüten

https://doi.org/10.46969/EZH.1490197

Abstract

Amaç: Epidural analjezi ve geleneksel analjezi uygulanan hastalarda jinekolojik kansere bağlı mortalitenin farklı olup olmadığını belirlemeyi ve ikinci olarak hangi analjezi yaklaşımının jinekolojik kanser prognozunda daha iyi olduğunu araştırmayı amaçladık.
Gereç ve Yöntem: Jinekolojik malignite nedeniyle ameliyat edilen hastalar kullanılan analjezi tipine göre iki çalışma grubuna ayrıldı: Epidural analjezi grubu (n=120) ve geleneksel analjezi grubu (n=88). Tüm veriler geriye dönük olarak hasta çizelgelerinden toplandı. Hastaların yaşı, vücut kitle indeksi (BKİ), ek hastalık varlığı, anestezi süresi, ameliyat sırasında yapılan kan transfüzyon miktarı, hastanede kalış süresi, yoğun bakımda kalış süresi, ameliyat sonrası enfeksiyon varlığı ve ameliyat sonrası tedavi şekli kaydedildi.
Bulgular: Cerrahi sonrası sağkalım geleneksel analjezi uygulanan hastalarda (88 hastanın 81’i), epidural analjeziye (120 hastanın 102’si) göre istatistiksel olarak fark olmaksızın daha yüksek olma eğilimindeydi (p=0.123). Diğer tüm faktörler kontrol edildikten sonra kan transfüzyonunun katsayısı -0,192 ve p değeri 0,007, komorbid hastalık varlığı katsayısı -0,163 ve p 0,022 değerine sahipti. Daha az miktarda kan transfüzyonu ve daha az eşlik eden hastalık, ameliyat sonrası hayatta kalma oranının artmasına katkıda bulunur. Geleneksel analjezi, epidural analjeziye göre daha yüksek sağkalım (katsayı=0,163, p=0,022) gösterdi. Diğer değişkenler hayatta kalma ile anlamlı bir korelasyon göstermedi.
Sonuç: Bu çalışma, analjezi yönteminin metastatik olmayan jinekolojik kanserli hastaların prognozuna etkisini araştıran önde gelen çalışmalardan biridir. Ameliyat sırasında daha az kan transfüzyonu yapılması ve eşlik eden hastalıkların daha az olması sağkalımın artmasına katkıda bulunur.

Keywords

analjezi;, epidural, prognoz

Comparison of The Effects of Epidural Analgesia and Conventional Analgesia on Survival in Patients Undergoing Gynecological Oncological Surgery: A retrospective analysis

Abstract

Purpose: We aimed to determine whether mortality due to gynecologic cancer differs in patients who received epidural analgesia versus conventional analgesia. Additionally, we aimed to investigate which analgesia approach results in a better prognosis for gynecologic cancer.
Materials and Methods: Patients who underwent surgery for a gynecologic malignancy were divided into two study groups based on the type of analgesia used: the Epidural Analgesia Group (n=120) and the Conventional Analgesia Group (n=88). All data were retrospectively collected from patient case charts. Variables recorded included patients’ age, body mass index (BMI), presence of comorbid diseases, duration of anesthesia, amount of blood transfusion. During surgery, duration of hospital stay, duration of intensive care unit stay, presence of postoperative infection, and type of postoperative treatment.
Results: Survival after surgery tended to be higher in patients who received conventional analgesia (81 out of 88 patients) compared to those who received epidural analgesia (102 out of 120 patients), although this difference was not statistically significant (p=0.123). After controlling for all other factors, the coefficient for blood transfusion was -0.192 with a p- value of 0.007, indicating that a lower amount of blood transfusion was associated with increased survival. Similarly, the coefficient for the presence of comorbid diseases was -0.163 with a p-value of 0.022, suggesting that fewer comorbidities contributed to better survival post-surgery. Conventional analgesia showed higher survival rates (coefficient=0.163,p=0.022) compared to epidural analgesia. None of the other variables showed a significant correlation with survival.
Conclusion: This study is among the pioneering research efforts to explore the impact of analgesia methods on the prognosis of patients with non-metastatic gynecologic cancer. A lower amount of blood transfusion during surgery and fewer comorbid diseases contribute to improved survival rates.

Keywords

analgesia, epidural, prognosis.

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