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Spinal analgesia improves surgical outcome after open nephrectomy for renal cell carcinoma: a randomized controlled study
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
2017 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 51, no 4, 277-281 p.Article in journal (Refereed) Published
Abstract [en]

Objective: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS).

Materials and methods: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique. Inclusion criteria were American Society of Anesthesiologists (ASA) score of III or less, age over 18 years and no chronic pain medication or cognitive disorders.

Results: The median LOS was 4 days for patients in the spinal group and 6 days in the epidural group (p = 0.001). There were no differences regarding duration of surgery, blood loss, RENAL score, tumor size or complications between the given analgesia methods. A limitation was that different anesthesiologists were responsible for administering spinal or epidural anesthesia, as in a real-world clinical situation.

Conclusions: In this randomized controlled study, spinal analgesia with clonidine was superior to continuous epidural analgesia in patients operated on with open nephrectomy, based on shorter LOS. A shorter LOS in the study group indicates faster mobilization and improved analgesia. Spinal analgesia did not carry more complications than epidural analgesia.

Place, publisher, year, edition, pages
2017. Vol. 51, no 4, 277-281 p.
Keyword [en]
Clonidine, epidural anesthesia, length of stay, nephrectomy, renal cell carcinoma, spinal anesthesia
National Category
Anesthesiology and Intensive Care Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-136672DOI: 10.1080/21681805.2017.1318300ISI: 000405483400008OAI: oai:DiVA.org:umu-136672DiVA: diva2:1113081
Available from: 2017-06-21 Created: 2017-06-21 Last updated: 2017-08-10Bibliographically approved

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Thurm, MaschaWinsö, OlaLjungberg, Börje
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