• 2014
  • 2013
  • 2012
  • 2011
  • 2010
  • 2009
  • 2008

The journal «ONCOSURGERY» 2012, Vol.4, No 3

Experience in using xenon anesthesia in radical surgery for laryngeal and laryngopharyngeal cancer

Avdeev SV1, Choinzonov EL1,2, Kushner AV1, Chizhevskaya SYu1

1) Cancer Research Institute, Siberian Branch of the Russian Academy of Medical Sciences,
2) Siberian State Medical University, Tomsk, Russia
Contact: Avdeev SV, e-mail:

The objective of the study was to assess the recovery from narcosis, systemic hemodynamics, respiratory function and postoperative complications in patients with stage Т2-4N0-1M0 laryngeal and laryngopharyngeal cancers received chemoradiotherapy and laryngectomy with lymphadenectomy. All patients were divided into 2 groups. Group 1 (n=27) underwent surgery under xenon anesthesia in the ratio Xe:O2=70%:30%. Group 2 (n=28) received sevoflurane combined with N2O. Recovery from xenon anesthesia was found to be significantly faster compared to that observed in the control group (0.78±3.2 versus 0.41±0.25 according to Aldrete Scoring System). Hemodynamic characteristics remained relatively stable after using both anesthesia modalities. Fentanyl was used in less doses in xenon group than in the control group (2.0 mkg/kg/h versus 5/0-5/5 mkg/kg/h). A significant reduction in exhalation rates (by 50-55%) after operation was observed in patients who received sevoflurane and N2O. Patients receiving xenon had a 20-25% reduction in exhalation rates as compared to the initial levels (difference was not statistically significant). Xenon anesthesia in surgery for laryngeal and laryngopharyngeal cancers resulted in more rapid recovery from narcosis, early physical activity and compensation of ventilation damages occurring in postoperative period.

KEY WORDS: laryngeal cancer, laryngectomy, xenon anesthesia, respiration function.

References

  1. Avdeev SV, Odyshev VM, Slonimskaya EM, Stakheeva MN, Strezh VA. Effect of xenon anesthesia and nitrous oxide in the adaptation status of patients with breast cancer. Scientific-practical conference «Xenon and inert gases in medicine». Moscow. 2010; 1-18.
  2. Burov NE, Potapov VN, Makeev GN. Xenon anesthesia. Moscow. 2000.
  3. Pavlov DB. Inert gases – a new class of drugs and therapeutic effects. Scientific-practical conference. «Xenon and inert gases in medicine». Moscow. 2008; 87-105.
  4. Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995; 7: 89-91.
  5. Arriaga MA, Jonnson JT, Kanel KT, Myers EN. Medical complications in total laryngectomy – incidence and risk-factors. Ann Otol Rhinl Laryngol. 1990; 99(8): 611-616.
  6. Farwell DG, Reilly DF, Weymuller EA. et al. Predictors of Perioperative Complications in Head and Neck Ptients. Arch. Otolaryngol. Yead Neck Surg. 2002; 128: 505-511.
  7. Ferrrier MB, Spuesens EB, Le Cessie S, et el. Morbidity as a Major Risk Factor for Mortality and Complicartions in Htad and Neck Patients. Arch. Otolaryngol. Head Neck Surg. 2005; 131: 27-32.
  8. Garg R, Darlong, V, Pandey R, Punj J. Anesthesia for Oncological ENT surgeries: Review. The Internet Journal of Anesthesiology. 2009; 20.
  9. Goto T, Nakata Y, Morita S. Will Xenon Be a Stranger or a Friend?: The Cost, Benefit, and Future of Xenon Anesthesia. Anesthesiology. 2003; 98(1): 1-2.
  10. Harold T Hoffman; Terence M Davidson, Clarence F Ward. Anesthesia in Septorhinoplasty:Effects of Halothane vs Nitrous Oxide Narcotic on Bleeding. Arch. Otolaryngol. 1982; 108(2): 83-86.
  11. Kvolik S, Glavas-Obrovac L, Sakic K, Margaretic D, Karner I. Anaesthetic implications of anticancer chemotherapy. Eur J Anaesthesiol. 2003; 20: 859-71.
  12. McCulloch TM, Jens NF,Girod DA, et el. Risk factor for pulmonary compliations in the postoperative head and neck surgery patient. Head Neck. 1997; 372-377.
  13. Rossaint R, Reyle-Hahn M, Schulte Esch J, et al. Multicenter Randomized Comparison of the Efficacy and Safety of Xenon and Isoflurane in Patients Undergoing Elective Surgery (CLINICAL INVESTIGATIONS). Anesthesiology. 2003; 98(1): 6-13.
  14. Young-Hoon Joo, MD; Dong-Il Sun, MD, PhD; Jung-Hae Cho, et al. Factors that predict postoperative pulmonary complications after supracricoid partial laryngectomy. Arch Otolaryngol Head Neck Surg. 2009; 135(11): 1154-1157.

P. 17-22

Publishers
«Oncokhirurgia Info»

10 Vostochnaia ul., suite 16, Moscow, 115280
Tel./fax: +7(499) 426-46-22
Tel.: +7(915) 356-03-07
E-mail:
URL: oncosurgery.oncology.ru


РСХО