Abstract:
BACKGROUND:Even the best cancer surgery is usually associated with minimal residual disease. Whether these remaining malignant cells develop into clinical recurrence is at least partially determined by adequacy of host defense, especially natural killer cell function. Anesthetics impair immune defenses to varying degrees, but nitrous oxide appears to be especially problematic. We therefore tested the hypothesis that colorectal-cancer recurrence risk is augmented by nitrous oxide administration during colorectal surgery. METHODS:We conducted a 4- to 8-year follow-up of 204 patients with colorectal cancer who were randomly assigned to 65% nitrous oxide (n = 97) or nitrogen (n = 107), balanced with isoflurane and remifentanil. The primary outcome was the time to cancer recurrence. Our primary analysis was a multivariable Cox-proportional-hazards regression model that included relevant baseline variables. In addition to treatment group, the model considered patient age, tumor grade, dissemination, adjacent organ invasion, vessel invasion, and the number of nodes involved. The study had 80% power to detect a 56% or greater reduction in recurrence rates (i.e., hazard ratio of 0.44 or less) at the 0.05 significance level. RESULTS:After adjusting for significant baseline covariables, risk of recurrence did not differ significantly for nitrous oxide and nitrogen, with a hazard ratio estimate (95% CI) of 1.10 (0.66, 1.83), P = 0.72. No two-way interactions with the treatment were statistically significant. CONCLUSION:Colorectal-cancer recurrence risks were not greatly different in patients who were randomly assigned to 65% nitrous oxide or nitrogen during surgery. Our results may not support avoiding nitrous oxide use to prevent recurrence of colorectal cancer. IMPLICATIONS STATEMENT:The risk of colorectal cancer recurrence was similar in patients who were randomly assigned to 65% nitrous oxide or nitrogen during colorectal surgery. TRIAL REGISTRATION:Current Controlled Clinical Trials NCT00781352 http://www.clinicaltrials.gov.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Fleischmann E,Marschalek C,Schlemitz K,Dalton JE,Gruenberger T,Herbst F,Kurz A,Sessler DIdoi
10.1186/1471-2253-9-1subject
Has Abstractpub_date
2009-02-03 00:00:00pages
1issn
1471-2253pii
1471-2253-9-1journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Quick and complete recovery of cognitive function after general anesthesia is desirable, particularly for working-age patients. Desflurane is less likely to have long-term effects than older-generation inhalational anesthetics, however, its short-term effects have not been fully investigated. Our objective w...
journal_title:BMC anesthesiology
pub_type: 杂志文章
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更新日期:2019-07-04 00:00:00
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journal_title:BMC anesthesiology
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更新日期:2017-03-03 00:00:00
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journal_title:BMC anesthesiology
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doi:10.1186/s12871-018-0644-z
更新日期:2018-12-03 00:00:00
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journal_title:BMC anesthesiology
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doi:10.1186/s12871-015-0113-x
更新日期:2015-10-06 00:00:00
abstract:BACKGROUND:Few studies have investigated the effect of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients underwent gynecological laparoscopic surgery. We investigated if adding dexmedetomidine to a morphine-based patient-controlled analgesia (PCA) could decrease the incidence of PONV in this high-...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2020-01-08 00:00:00
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journal_title:BMC anesthesiology
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更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Early prediction of outcome would be useful for an optimal intensive care management of liver transplant recipients. Indocyanine green clearance can be measured non-invasively by pulse spectrophometry and is closely related to liver function. METHODS:This study was undertaken to assess the predictive value ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-103
更新日期:2014-11-15 00:00:00
abstract:BACKGROUND:Abnormal laryngeal structures are likely to be associated with a difficult laryngoscopy procedure. Currently, laryngeal structures can be measured by ultrasonography, however, little research has been performed on the potential role of ultrasound on the evaluation of a difficult laryngoscopy. The present stu...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01053-3
更新日期:2020-06-02 00:00:00
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journal_title:BMC anesthesiology
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更新日期:2014-10-17 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:BMC anesthesiology
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doi:10.1186/s12871-016-0223-0
更新日期:2016-08-03 00:00:00
abstract:BACKGROUND:Children require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature...
journal_title:BMC anesthesiology
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doi:10.1186/s12871-019-0897-1
更新日期:2019-12-18 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0703-0
更新日期:2019-03-04 00:00:00
abstract:BACKGROUND:The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use ...
journal_title:BMC anesthesiology
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pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0209-y
更新日期:2016-07-30 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12871-018-0551-3
更新日期:2018-07-18 00:00:00
abstract:BACKGROUND:Data on the best norepinephrine bolus dose for management of hypotension are limited. The aim of this study was to compare the efficacy and safety of two norepinephrine bolus doses in the rescue management of maternal hypotension during cesarean delivery. METHODS:This randomized, controlled trial included m...
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pub_type: 杂志文章
doi:10.1186/s12871-020-01004-y
更新日期:2020-04-17 00:00:00
abstract:BACKGROUND:Tracheostomy is recommended for patients receiving mechanical ventilation (MV) for 14 days or more in the intensive care unit (ICU). Nevertheless, many patients undergoing prolonged MV remain intubated via the translaryngeal route. The aim of this study was to examine the influence of tracheostomy and persis...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0159-9
更新日期:2015-12-15 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:BMC anesthesiology
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journal_title:BMC anesthesiology
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更新日期:2018-06-06 00:00:00
abstract:BACKGROUND:The sensory innervation of the shoulder is complex and there are variations in the branching patterns of the sensory fibres. Articular branches from the axillary nerve to the subacromial bursa are described in more than 50% of investigated shoulders but the isolated contribution of sensory input from the axi...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2020-01-31 00:00:00
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更新日期:2021-01-07 00:00:00
abstract:BACKGROUND:Surgical patients are asked to fast for a sufficient duration to ensure that the amount of residual liquid in the stomach is within the safe range, thereby reducing the risk of gastric reflux perioperatively. The authors hypothesized that subjective hunger numerical rating scale (NRS) score could also help a...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0470-3
更新日期:2018-01-12 00:00:00
abstract:BACKGROUND:Ultrasound gels may contain propylene glycol and glycerol, which are neurotoxic in high concentrations. If the needle passes through gel during regional anesthesia, gel may be injected near the nerve. It is unknown if this practice poses a risk for neurotoxicity. Using an animal model, we assessed the histol...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-18
更新日期:2013-09-03 00:00:00
abstract:BACKGROUND:Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hy...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0114-9
更新日期:2015-10-06 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0277-z
更新日期:2016-11-16 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0852-1
更新日期:2019-10-09 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs frequently after liver transplant surgery and is associated with significant morbidity and mortality. While the impact of intraoperative hypotension (IOH) on postoperative AKI has been well demonstrated in patients undergoing a wide variety of non-cardiac surgeries, it remain...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01228-y
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:To investigate the optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough (FIC) suppression. METHODS:Patients of 180 undergoing elective surgery with general anesthesia, aged 18-65 years, BMI 18.5-30 kg/m2, ASA I or II, were equally randomized into four groups (n = 45) to receive intravenous p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0765-z
更新日期:2019-06-01 00:00:00