Prostate brachytherapy under hypnosedation: A prospective evaluation
| Autor: | Samy Horn, Edwige Rigal, Vincent Piriou, Olivier Chapet, Cécile Clamens, Corina Udrescu, Sonya Gaudioz, Alain Ruffion, Fabrice Lorchel |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Visual analogue scale medicine.medical_treatment Brachytherapy Remifentanil Anesthesia General Anesthesia Spinal 030218 nuclear medicine & medical imaging Sufentanil 03 medical and health sciences 0302 clinical medicine Hypnosis Anesthetic Humans Pain Management Medicine Radiology Nuclear Medicine and imaging Prospective Studies Aged Pain Measurement Bupivacaine business.industry Prostatic Neoplasms Middle Aged Oncology 030220 oncology & carcinogenesis Anesthesia Midazolam business Propofol Prostate brachytherapy medicine.drug |
| Zdroj: | Brachytherapy. 18:22-28 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2018.10.004 |
| Popis: | PURPOSE Hypnosedation (HS) for brachytherapy has been proposed in patients with prostate cancer and has been evaluated. MATERIALS AND METHODS 79 patients were treated with brachytherapy under HS. The Visual Analog Scale questionnaire was used to assess comfort and anxiety and the lowest, mean, and highest level of pain. Data for 79 patients who underwent general anesthesia (GA) and 37 patients who underwent spinal anesthesia (SA) treated at the same period were compared with HS group in terms of medication and treatment duration. RESULTS 11 patients (13.9%) requested a GA, because they did not reach the hypnotic level. For the remaining 68 patients, the mean pain and comfort scores evaluated just after the intervention were 3.1 and 7.4, respectively. At 8 weeks, the scores were 2.8 and 7.5, respectively. 66 patients (97%) would choose this approach again and recommend it to other patients. The patients in the HS group received significant less medications than in the GA (remifentanil, propofol, ketamine, phenylephrine, ephedrine…) or SA (sufentanil, midazolam, morphine, bupivacaine…) groups with mean values of 3.1 vs. 7.9 vs. 5.6 (p < 0.0001), respectively. HS increased the mean time of surgery room occupation by 12 min vs. GA and by 20 min vs. SA. However, the recovery room occupation is avoided with HS (GA = 61 min and SA = 67 min) and a shorter duration of a need for a urinary catheter was noted. CONCLUSIONS HS is a feasible and comfortable method of anesthesia and a good alternative to GA and SA for patients undergoing prostate brachytherapy, with reduced treatment duration and number of medications. |
| Databáze: | OpenAIRE |
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