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Patient's QoL after open kidney surgery in a randomized study of spinal versus epidural analgesia in patients with renal cell carcinoma
2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 53, p. 17-17Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objective: This study was aimed to evaluate the patients perspectives, before and one month after surgery in patients treated with open surgery for renal cell carcinoma (RCC). Can effective perioperative analgesia be part of a multimodal approach to minimize morbidity and improve postoperative management [1].

Material and Methods: A total of 135 patients with RCC in all stages 2012-2015, were randomized to receive either spinal analgesia with clonidine, or epidural analgesia in addition to the general anesthesia: The patients were stratified according to surgical technique. Inclusion criteria: ASA score I-III, age >18 years, no chronic pain medication or cognitive disorders. The patients survey used was based on the EORTC QLQ-C30. Wilcoxon Signed Rank test and Mann-Whitney-U tests were used for statistical evaluation.

Results: A majority of the patients (117 of 135, 86%) responded to the survey. Patients groups treated with partial nephrectomy or radical nephrectomy, had significantly reduced physical and social functioning while emotional functioning improved postoperatively compared with preoperatively. In both surgical groups the patients reported significant negative financial difficulties postoperatively. Similar results was achieved for patients treated with either spinal or epidural anesthesia. The epidural group of patients experienced more negative social functioning but had an improved global health. When comparing the surgical procedures there was no significant difference in the quality of life parameters. However when comparing the analgesic groups, spinal anesthesia had significantly better physical and social functioning after surgery while the patients in the epidural group reported better global health.

Conclusion: Patients randomized to be treated with spinal analgesia with clonidine, had better physical and social functioning postoperatively than patients randomized to be treated with epidural analgesia.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 53, p. 17-17
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-161601DOI: 10.1080/21681805.2019.1619285ISI: 000472734500034OAI: oai:DiVA.org:umu-161601DiVA, id: diva2:1337956
Note

Supplement: 221

Special Issue: SI

Meeting Abstract: NO2-02

Available from: 2019-07-18 Created: 2019-07-18 Last updated: 2019-07-18Bibliographically approved

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Thurm, MaschaWinsö, OlaLjungberg, Börje

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