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J Clin Anesth ; 27(8): 672-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26371714

RESUMO

STUDY OBJECTIVE: To assess whether the use of intraoperative opioids is associated with poor recurrence-free survival (RFS) and overall survival (OS) after lung cancer surgery. DESIGN: Retrospective study. SETTING: Academic hospital. SUBJECTS: Patients with laryngeal primary or recurrent laryngeal squamous cell carcinoma who had surgery. INTERVENTIONS: Intravenous opioids (remifentanil, fentanyl, sufentanil, and hydromorphone). MEASUREMENTS: Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on OS and RFS. MAIN RESULTS: A total of 195 patients were included. All received opioids intraoperatively. The multivariate analysis demonstrated that age (hazard ratio [HR], 1.03; P = .005), negative margin status (HR, 0.163; P = .001], postoperative chemotherapy (HR, 7.38; P < .001), and concurrent chemotherapy and radiation (HR, 3.11; P < .001) treatment and fentanyl equivalent use (HR, 1.001; P = .02) were all predictor factors for 3- and 5-year RFS. The same variables were predictor factors for OS (age: HR, 1.03 [P = .003]; negative margin status: HR, 0.14 [P = .001]; postoperative chemotherapy: HR, 4 [P < .0001]; and fentanyl equivalent use: HR, 1.001 [P = .02]). CONCLUSIONS: Our study demonstrates a very weak association between the use of intraoperative opioids and cancer recurrence after laryngeal squamous cell carcinoma surgery.


Assuntos
Analgésicos Opioides/administração & dosagem , Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias Laríngeas/cirurgia , Administração Intravenosa , Idoso , Analgésicos Opioides/efeitos adversos , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Cuidados Intraoperatórios , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Taxa de Sobrevida
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