Why the study?
Does regional anaesthesia reduce postoperative complications compared to general anaesthesia in women undergoing surgical management of vulval cancer?
Does regional anaesthesia reduce postoperative complications compared to general anaesthesia in women undergoing surgical management of vulval cancer?
Regional anaesthesia is a safe and well-tolerated alternative to general anaesthesia for vulval cancer surgery, particularly in elderly and comorbid patients.
Does not support preferring regional over general anaesthesia to reduce complications; leaves open the need for larger prospective trials in vulval cancer surgery.
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.
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Moss et al. (2014) studied this question.
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