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Introduction <p>Women aged ≥ 65 with multiple comorbidities are at increased risk of perioperative complications, loco-regional anaesthetic techniques (LRA) may reduce perioperative complications compared to general anaesthesia&#xa0;(GA); however, evidence specific to patients aged ≥ 65 is limited.</p> Methods <p>A systematic search was conducted using Cochrane, Embase, MEDLINE and Web of Science from database inception to 7 April 2025. Studies comparing LRA to GA, with any number of women aged ≥ 65 undergoing primary breast cancer surgeries, were included.</p> Results <p>Eight studies with a total of 255,088 women, of whom 55,310 were aged ≥ 65, were included. Four studies were prospective and four were retrospective. 192,453 women received GA. Four studies compared local anaesthesia alone (number of women aged ≥ 65, <i>n</i> = 54,852) to GA, and one study each compared local + regional anaesthesia (<i>n</i> ≥ 65 = 389), pectoral nerve blocks (<i>n</i> ≥ 65 = 42), paravertebral block (<i>n</i> ≥ 65 = 26) and thoracic epidural (<i>n</i> ≥ 65 = 1) to GA. Overall, LRA techniques had lower rates of post-operative nausea and vomiting, confusion and operative duration.</p> Conclusions <p>LRA may have a role in patients who are unfit for or cannot undergo GA for breast cancer surgery; however, data specific to women ≥ 65&#xa0;years are sparse and there are many confounding factors which impact usability of LRA techniques, for example type of breast and axillary surgery and availability of technique.</p>

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Impact of Loco-regional Anaesthetic Techniques Versus General Anaesthesia in Women Aged ≥ 65 Undergoing Primary Breast Cancer Surgery: A Systematic Review of the Literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Catriona Staunton,
  • Rachel Lee,
  • Troy S. Wildes,
  • Nick E. Heiser,
  • Kwok-Leung Cheung,
  • Ruth Mary Parks

摘要

Introduction

Women aged ≥ 65 with multiple comorbidities are at increased risk of perioperative complications, loco-regional anaesthetic techniques (LRA) may reduce perioperative complications compared to general anaesthesia (GA); however, evidence specific to patients aged ≥ 65 is limited.

Methods

A systematic search was conducted using Cochrane, Embase, MEDLINE and Web of Science from database inception to 7 April 2025. Studies comparing LRA to GA, with any number of women aged ≥ 65 undergoing primary breast cancer surgeries, were included.

Results

Eight studies with a total of 255,088 women, of whom 55,310 were aged ≥ 65, were included. Four studies were prospective and four were retrospective. 192,453 women received GA. Four studies compared local anaesthesia alone (number of women aged ≥ 65, n = 54,852) to GA, and one study each compared local + regional anaesthesia (n ≥ 65 = 389), pectoral nerve blocks (n ≥ 65 = 42), paravertebral block (n ≥ 65 = 26) and thoracic epidural (n ≥ 65 = 1) to GA. Overall, LRA techniques had lower rates of post-operative nausea and vomiting, confusion and operative duration.

Conclusions

LRA may have a role in patients who are unfit for or cannot undergo GA for breast cancer surgery; however, data specific to women ≥ 65 years are sparse and there are many confounding factors which impact usability of LRA techniques, for example type of breast and axillary surgery and availability of technique.