Effects of Different Anesthetic Techniques on Intraoperative and Postoperative Pain Levels and Cognitive Function in Patients Undergoing Hepatectomy for Liver Cancer

NCT ID: NCT07097220

Last Updated: 2025-07-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

106 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-16

Study Completion Date

2025-06-15

Brief Summary

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To evaluate the effects of general anesthesia (GA) versus combined general and epidural anesthesia (GEA) on postoperative pain, cognitive dysfunction (POCD), hospital stay, and recovery quality in liver cancer patients undergoing hepatectomy.

A retrospective analysis of 80 liver cancer patients was conducted, categorized by analgesic adequacy, pain recovery, and POCD incidence: adequate vs. inadequate analgesia (n=50 vs. n=30), favorable vs. delayed pain recovery (n=36 vs. n=44), and POCD vs. non-POCD (n=42 vs. n=38). Based on these results, a prospective study (April 2024-April 2025) enrolled patients scheduled for elective hepatectomy, assigned to the GA group (n=59) or GEA group (n=47). Primary outcomes included intraoperative analgesic consumption, postoperative VAS pain scores, MoCA cognitive scores, hospital stay length, and adverse event rates.

Detailed Description

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Compared to GA alone, combined epidural-general anesthesia provides better perioperative pain control, reduces POCD risk, shortens hospitalization, and enhances recovery. GEA is a preferable anesthetic approach for liver cancer surgery.

Conditions

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Liver Cancer Hepatectomy Anesthesia Techniques Postoperative Pain Cognitive Dysfunction Epidural-general Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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general anesthesia group

In the General Anesthesia (GA) group (n = 59), patients received combined intravenous-inhalation general anesthesia. Anesthesia induction was performed using propofol and remifentanil, followed by maintenance with sevoflurane to ensure adequate anesthetic depth and hemodynamic stability throughout the procedure.

Group Type EXPERIMENTAL

General Anesthesia (GA) group

Intervention Type DRUG

In the General Anesthesia (GA) group (n = 59), patients received combined intravenous-inhalation general anesthesia. Anesthesia induction was performed using propofol and remifentanil, followed by maintenance with sevoflurane to ensure adequate anesthetic depth and hemodynamic stability throughout the procedure.

General-Epidural Anesthesia group

In the General-Epidural Anesthesia (GEA) group (n = 47), patients received the same general anesthesia protocol as the GA group, in addition to epidural anesthesia. An epidural catheter was placed preoperatively at the T7-T9 vertebral level using a midline approach under strict aseptic conditions. Following successful catheterization and confirmation of proper placement, a continuous intraoperative infusion of 0.25% ropivacaine was administered via the epidural route to provide segmental analgesia and reduce intraoperative opioid requirements.

Group Type EXPERIMENTAL

General-Epidural Anesthesia (GEA) group

Intervention Type DRUG

In the General-Epidural Anesthesia (GEA) group (n = 47), patients received the same general anesthesia protocol as the GA group, in addition to epidural anesthesia. An epidural catheter was placed preoperatively at the T7-T9 vertebral level using a midline approach under strict aseptic conditions. Following successful catheterization and confirmation of proper placement, a continuous intraoperative infusion of 0.25% ropivacaine was administered via the epidural route to provide segmental analgesia and reduce intraoperative opioid requirements.

Interventions

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General Anesthesia (GA) group

In the General Anesthesia (GA) group (n = 59), patients received combined intravenous-inhalation general anesthesia. Anesthesia induction was performed using propofol and remifentanil, followed by maintenance with sevoflurane to ensure adequate anesthetic depth and hemodynamic stability throughout the procedure.

Intervention Type DRUG

General-Epidural Anesthesia (GEA) group

In the General-Epidural Anesthesia (GEA) group (n = 47), patients received the same general anesthesia protocol as the GA group, in addition to epidural anesthesia. An epidural catheter was placed preoperatively at the T7-T9 vertebral level using a midline approach under strict aseptic conditions. Following successful catheterization and confirmation of proper placement, a continuous intraoperative infusion of 0.25% ropivacaine was administered via the epidural route to provide segmental analgesia and reduce intraoperative opioid requirements.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically or radiologically confirmed primary liver cancer (HCC or cholangiocarcinoma)
* Scheduled for elective open or laparoscopic radical hepatectomy
* Age 18-75 years
* ASA Physical Status I-III
* Child-Pugh class A or B liver function
* Normal preoperative MoCA score (≥26)
* Willing to participate and provide informed consent

Exclusion Criteria

* Severe cardiovascular, pulmonary or renal disease (ASA IV/V)
* Chronic pain disorders or preoperative opioid use (\>3 months)
* Known neurologic/psychiatric conditions (dementia, stroke, epilepsy)
* Concurrent major procedures (e.g., vascular resection)
* Intraoperative conversion to palliative surgery
* Massive intraoperative hemorrhage (\>2000 mL)
* Coagulopathy (INR \>1.5 or platelets \<50×10⁹/L)
* Spinal abnormalities precluding epidural catheterization
* Pregnancy or lactation
* Allergy to local anesthetics or study medications
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sir Run Run Shaw Hospital, Qingchun Campus, Zhejiang University School of Medicine,

OTHER_GOV

Sponsor Role lead

Responsible Party

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Juhui Chen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

Hangzhou, Zhejiang, China

Site Status

Countries

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China

Other Identifiers

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No. 2025-0355

Identifier Type: -

Identifier Source: org_study_id