[The effect of neoadjuvant chemotherapy on patient controlled intravenous analgesia postoperatively in ovarian cancer patients].
OBJECTIVE
To investigate the effect of neoadjuvant chemotherapy on patient controlled intravenous analgesia (PICA) postoperatively in ovarian cancer patients.


METHODS
Sixty three patients with ovarian cancer (ASA I--III grade) were selected. They were divided into 2 groups according to with or without neoadjuvant chemotherapy: neoadjuvant chemotherapy group (N) 33 cases, direct operation group (D) 30 cases. Both of them were completed with tumor cell reduction-extinction operation under total intravenous general anesthesia. Patients' chemotherapy-induced peripheral neuropathy (CIPN) was assessed by the total neuropathy score exclusively clinically-based (TNSc) preoperatively, the assessment of analgesic effect and side-effect was performed postoperatively.


RESULTS
No statistically significant difference between the two groups (P > 0.05) on ages, body mass index, ASA grades and Karnofsky scores. Patients in group N were significantly lower than that of group D (P < 0.05) on the VAS scores at 2, 4, 8 h postoperatively, the pressure times and effective times of Bolus and the total consumption amount of analgesic drug in the whole process of analgesia treatment But the scores on nausea and vomiting of group N were significantly higher than that of group D (P < 0.05). There were no significant differences on Bruggemann comfort scale at 2, 4, 8, 12 h postoperatively, dizziness scores, pruritus scores and Ramsay Sedation scores between this two groups (P > 0.05). There was negative linear correlation between the total consumption amount of analgesic drug in the whole process of analgesia treatment and TNSc scores (r = -0.881, P = 0.048), and there was positive linear correlation between nausea scores and TNSc scores (r = 0.920, P = 0.027).


CONCLUSIONS
Patients with neoadjuvant chemotherapy have peripheral neuropathy at different degree before operation. The more serious of peripheral neuropathy, the less demand of PCIA analgesic drug postoperatively and with more side effects occur, such as nausea.
Department of Anesthesiology, Zhejiang Cancer Hospital, Hangzhou, China. fangjunok@126.com
Jun
J
Fang
Kang-jie
KJ
Xie
D000328:Adult; D016058:Analgesia, Patient-Controlled; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010051:Ovarian Neoplasms / Q000628:therapy*; D010149:Postoperative Pain / Q000628:therapy*