The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis

被引:1
|
作者
Zhang, Yizhou [1 ]
Chen, Qichen [1 ]
Chen, Xiao [1 ]
Zhang, Mingzhu [2 ]
Li, Peng [2 ]
Huang, Zhen [1 ]
Zhao, Hong [1 ]
Wu, Hongliang [2 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Dept Hepatobiliary Surg, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, 17 Nanli, Beijing 100021, Peoples R China
[2] Chinese Acad Med Sci & Peking Union Med Coll, Dept Anesthesiol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, 17 Nanli, Beijing 100021, Peoples R China
来源
JOURNAL OF CANCER | 2022年 / 13卷 / 11期
基金
中国国家自然科学基金;
关键词
Colorectal liver metastasis; fentanyl; opioids; prognosis; recurrence; KILLER-CELL ACTIVITY; CANCER RECURRENCE; OPIOID USE; SURGERY; COMPLICATIONS; COLONIZATION; SURVIVAL;
D O I
10.7150/jca.74674
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: No previous studies have reported the effect of intraoperative opioid consumption in colorectal liver metastasis (CRLM). Methods: Medical records of patients who received simultaneous resection of CRLM were retrospectively reviewed. Patients with epidural anesthesia, intraoperative morphine, or intraoperative oxycodone were excluded. Patients were separated into high- and low-dose groups by median intraoperative equianalgesic fentanyl dose. Short-term outcomes, progression-free surcical (PFS) and overall survival (OS) were compared between groups before and after 1:1 propensity score matching (PSM). Univariable and multivariable Cox regression analysis were performed to identify independent predictors of survival. Results: The final study population included 343 patients. Patients were separated into the low dose group (n=172) and the high dose group (n=171) by median intraoperative equianalgesic fentanyl dose (8.33 mu g/kg). After PSM, 55 patients in the low dose group were matched to 55 patients in the high dose group and the baseline characteristics of the two groups were balanced. The two groups had no statistically significance difference in severity and categories of postoperative complications before and after PSM. Before PSM, the two groups had similar PFS (median 10.2 vs. 12.4 months, P=0.54) and OS (median 59.0 vs. 58.3 months, P=0.76). Univariate and multivariate Cox regression analyses revealed no statistically significant association between intraoperative equianalgesic fentanyl and PFS (multivariate HR=0.852, 95% CI 0.655-1.11, P=0.235) and OS (multivariate HR=1, 95% CI 0.68-1.49, P = 0.981). After PSM, the two groups also had similar PFS (median 9.2 vs. 10.7 months, P=0.98) and OS (median 51.0 vs. 46.0 months, P=0.39). Univariate and multivariate Cox regression analyses revealed no statistically significant association between intraoperative equianalgesic fentanyl and PFS (multivariate HR=1.05, 95% CI 0.632-1.73, P=0.861) and OS (multivariate HR=1.74, 95% CI 0.892-3.38, P = 0.105). Conclusion: Intraoperative opioids consumption was not correlated with outcomes of CRLM patients treated with simultaneous resection.
引用
收藏
页码:3189 / 3198
页数:10
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