Recovery profiles of general anesthesia and spinal anesthesia for chemotherapeutic perfusion with circulatory block (stop-flow perfusion).
BACKGROUND
Chemotherapeutic stop-flow perfusion is a new investigational treatment for locally advanced cancers that is usually performed under general anesthesia (GA), and, less frequently, under spinal anesthesia (SA). We designed this clinical trial to compare the clinical profiles of GA and SA for stop-flow perfusion.


METHODS
Anesthesia and recovery times, scores on visual analog scales for postoperative pain, and postoperative nausea and vomiting, and admission to the postanesthesia care unit were measured in 40 cancer patients who randomly received either GA with propofol, nitrous oxide/sevoflurane, and fentanyl, or SA with bupivacaine hydrochloride for lower limb or pelvic stop-flow perfusion.


RESULTS
GA and SA did not differ in times to achieve home readiness or patient satisfaction. Compared with GA, SA significantly (P < 0.05) reduced anesthesia times (34 vs 16 min), postoperative visual analog scale scores for pain (5 vs 0) and nausea (8 vs 2), and the number of admissions to the postanesthesia care unit (9 vs 0).


CONCLUSIONS
For stop-flow perfusion, GA and SA are both effective, but SA provides faster recovery, superior analgesia, and less postoperative nausea and vomiting in the immediate postoperative period.
Carron
Michele
M
Department of Pharmacology and Anesthesiology, University of Padova, Padova, Italy.
Freo
Ulderico
U
Innocente
Federico
F
Veronese
Stefano
S
Pilati
Pierluigi
P
Jevtovic-Todorovic
Vesna
V
Ori
Carlo
C
D000368:Aged; D000369:Aged, 80 and over; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016503:Drug Delivery Systems / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010477:Perfusion / Q000379:methods*
D000970:Antineoplastic Agents