Effect of regional versus general anaesthesia on postoperative opioid consumption, clinical outcomes and cognitive function in Chinese patients undergoing metastatic cancer surgery

Abstract

Purpose: To compare postoperative opioid consumption, inflammatory biomarkers, cognitive function and safety profile of regional anesthesia (RA) versus general anesthesia (GA) in Chinese patients undergoing metastatic cancer surgery.Method: Chinese patients undergoing metastatic cancer surgery were enrolled and received either RA or GA) in allocation ratio of 1:1. The following efficacy variables were assessed: 1) pain score was measured on VAS scale; 2) post-operative consumption; 3) inflammatory biomarkers; 4) cognitive function; 5) clinical outcomes. Safety was also assessed.Results: Data for a total of 220 patients were analyzed. Compared to GA alone, the combination of RA and GA demonstrated significantly greater reduction in post-operative pain with decreased postoperative opioid consumption. Also, RA/GA combination inhibited inflammatory response when compared to patients who received GA only, indicating that RA + GA improved immune response in patient undergoing surgical intervention. The severity of signs and symptoms of dementia were similar at baseline visit (p > 0.05). Patients of RA/GA group had significantly greater relief in signs and symptoms of dementia/cognitive impairment, when compared to the GA-treated patients (p < 0.05). However, incidence of complications (including adverse events) was comparable for both groups (p > 0.05). Additionally, RA/GA was also associated with shorter length of hospital stay, compared to GA.Conclusion: RA/GA combination demonstrates significantly greater improvement in the level of clinical outcomes, decreases postoperative opioid consumption, and improves cognitive functions when compared to GA in Chinese patients undergoing metastatic cancer surgery.