Table 2 Summary of studies on gastric cancer that compare GA with GA combined with epidural anesthesia/analgesia
Study (author/year) | Method | Intervention | Anaesthesia methods and/or anesthetic agents | Notes |
|---|---|---|---|---|
(Pei et al. 2020) | Retrospective | GA vs EGA | GA (n = 97) Anesthetic agents (no information) EGA (n = 97) Anesthetic drugs (no information) (patients were matched according to the propensity score) | EGA did not show a significant reduction in the incidence of recurrence and/or metastasis |
(Wang et al. 2019) | Retrospective randomized observer blinded study | GA vs EGA | GA (n = 25) I = midazolam + propofol + sufentanil + cisatracurium M = propofol + remifentanil infusion Postoperative analgesia: IV PCA (sufentanil) EGA (n = 25) I = midazolam + propofol + sufentanil + cisatracurium M = propofol + epidural PCA (ropivacaine + sufentanil) Postoperative analgesia: epidural PCA (ropivacaine + sufentanil) | EGA decreases immunosuppression gastric cancer resection |
(Wang et al. 2017) | Retrospective | GA vs EGA | GA (n = 2856) I = midazolam + propofol + fentanyl M = (propofol/sevoflurane) + (remifentanil infusion/fentanyl) Postoperative analgesia: IV PCA (sufentanil or fentanyl) EGA (n = 1362) I = anesthetic drugs (no information) M = anesthetic drugs (no information) + epidural anesthesia (ropivacaine/levobupivacaine infusion) Postoperative analgesia: epidural PCA (ropivacaine/levobupivacaine + fentanyl) | EGA and epidural PCA may be associated with the improved overall survival |
(Wang et al. 2016) | Retrospective | GA vs EGA | GA (n = 116) I = midazolam + propofol + sufentanil M = propofol + remifentanil infusion EGA (n = 157) I = midazolam + propofol + sufentanil M = propofol + epidural anesthesia (ropivacaine or levobupivacaine infusion) | EGA had no effect on the long-term survival, but younger patients who received EGA were more likely to have longer survival |
(Shin et al. 2017) | Retrospective | Epidural analgesia (PCA) vs IV analgesia (PCA) | GA with IV PCA (n = 374) I = anesthetic agents (no information) M = remifentanil + sevoflurane + N20 Postoperative analgesia: IV PCA (fentanyl) EGA with epidural PCA (n = 3425) I = anesthetic agents (no information) M = remifentanil + (enflurane/isoflurane) + N20 Postoperative analgesia: epidural PCA (ropivacaine + fentanyl) | Postoperative use of epidural analgesia was not found to be associated with reduced recurrence or mortality |