Optimization of Anesthetic Management of Peri- and Postoperative Period in Surgical Treatment of Colorectal Cancer

K.O. Chebanov, I.V. Baranov, S.P. Novikov, Yu.I. Olefir, S.A. Hryshko, O.V. Vasylishin, R.K. Karas


The purpose of the research — to select the optimal method of anesthesia to protect patients from operating aggression in the surgical treatment for colorectal cancer. We have performed a comparative analysis of clinical data and treatment outcomes when using ataralgesia, followed by analgesia with narcotic analgesics, and combined technique using low-flow sevoflurane anesthesia and epidural analgesia, with subsequent continuous epidural anesthesia. It was shown a significant advantage of the combined method over the total intravenous anesthesia due to: normodynamic type of hemodynamics during the entire surgery, early regression of postanesthesia depression and possible patient’s extubation in the operating room, the effective analgesia in the early postoperative period. Technique of continuous epidural analgesia in comparison with opiate analgesia provided a significant reduction in the need for opioid analgesics, efficient and high-quality analgesia in the postoperative period, leveled the side effects of opioid drugs, reduced the length of stay of the patient in the intensive care unit. The implemented methodology has reduced the incidence of postoperative mortality, the number of complications, average length of hospital stay and rate of patients’ readmission to the intensive care unit.


colorectal cancer; low-flow anesthesia; combined anesthesia; continuous epidural analgesia; sevoflurane


American Cancer Society. Colorectal Cancer Facts & Figures 2014–2016. — Atlanta: American Cancer Society, 2014. — 32 р.

National Cancer Registry of Ukraine. — Bulletin of National Cancer Registry of Ukraine (English). — 2015. — Vol. 16.

Ovechkin A.M., Sviridov S.V. Post-operative pain and pain management: state of the art // Medical emergency conditions. — 2011. — 6. — 20-31. — ​Russian.

Frances E.L., Jonathan M., Patrick A.S. The µ-Opioid Receptor in Cancer Progression Is There a Direct Effect? // Anesthesio­logy. — 2012. — 116. — 940-945.

Mathew B. et al. The novel role of the mu opioid receptor in lung cancer progression: a laboratory investigation // Anesth. Analg. — 2011. — 112(3). — 558-567.

Shavit Y., Lewis J.W., Terman G.W. Opioid peptides mediate the suppressive effect of stress on natural killer cell cytotoxicity // Science. — 1984. — 223. — 188-190.

Cata J.P., Gottumukkala V., Thakar D., Keerty D., Gebhardt R., Liu D.D. Effects of postoperative epidural analgesia on recurrence-free and overall survival in patients with nonsmall cell lung cancer // J. Clin. Anesth. — 2014 Feb. — 26(1). — 3-17.

Rodgers A., Walker N., Schug S. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomized trials // British Journal of Anaesthesia. — 2000. — 321. — 1493.

Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management // Anesthesiology. — 2012. — 116(2). — 248-73.

Werner M.U., Soholm L., Rotboll-Nielsen P., Kehlet H. Does an acute pain service improve postoperative outcome // Anesthesia & Analgesia. — 2002. — 95. — 1361-1372.

Magdalena D., Georgescu C.C., Tantu M. Methods of postoperative analgesia — ​administration of epidural bupivacaine in patients with colon cancer undergoing surgery // Current Health Sciences Journal. — 2013. — ​Vol. 39(1). — 35-38.

Kresimir O., Zrinka S. The Role of Epidural Anesthesia and Analgesia in Surgical Practice // Ann. Surg. — 2004. — 240(3). — 561-562.

Biki B., Mascha E., Moriarty D.C., Fitzpatrick J.M., Sessler D.I., Buggy D.J. Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: a retrospective analysis // Anesthesiology. — 2008. — 109(2). — 180-187.

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