title: The role of regional anaesthesia in the surgical management of vulval malignancy.
abstract: Abstract Surgical excision is the management of choice in vulval cancer however, the patient population are typically elderly and comorbid, for whom general anaesthesia (GA) carries considerable risk. The outcome of 107 procedures were reviewed in order investigate the postoperative complication rates associated with general and regional anaesthesia for the surgical management of vulval cancer. GA was used in 78 (72.9%) cases; 27 (22.9%) had a regional anaesthetic (spinal/epidural/ileoinguinal) and two women had a GA following a failed spinal anaesthetic. Women having a regional anaesthetic were significantly older (p = 0.0198), had a higher ACE (p = 0.0001) and ASA score (p < 0.0001) than those having a GA. There was an association between GA and grade II+ complications, compared with regional techniques (odds ratio, OR 2.72) but this was not significant due to the small number of events. Regional anaesthetic techniques are safe, well-tolerated alternatives to GA for the surgical management of vulval cancer, especially in an elderly and comorbid population.
authors: Pan Birmingham Gynaecological Cancer Centre , Birmingham , UK.
authors: E L
authors: EL
authors: Moss
authors: P W
authors: PW
authors: Jones
authors: D
authors: D
authors: Newbould
authors: D M
authors: DM
authors: Luesley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000706:statistics & numerical data*; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D014846:Vulvar Neoplasms / Q000601:surgery*
keywords: Anaesthetic; postoperative complication; regional anaesthetic; surgery; vulval cancer