Analysis of early postoperative complications in patients with malignant oropharyngeal tumors treated with enkephalins

The surgical stage of treatment of patients with oropharyngeal cancers plays a leading role in the treatment and increases overall survival. However, surgical interventions are associated with high risks of postoperative complications, which can complicate the rehabilitation period and affect the overall outcome of treatment. Therefore, most studies are currently focused on optimizing the treatment strategy to reduce the incidence of postoperative complications. One of the possible options for perioperative management includes the use of a preoperative carbohydrate load and dalargin. The purpose of the study was to evaluate the role of anesthesia with the inclusion of dalargin in decreasing early postoperative morbidity in patients with oropharyngeal cancer. Material and methods. We analyzed the immediate outcomes of surgical treatment of 60 patients with malignant tumors of the oropharyngeal region, which were divided into 2 groups. The groups were comparable in terms of tumor stage and the extent of surgical treatment. In the main group (30 patients), a preoperative carbohydrate load was used, and during anesthesia, dalargin was administered at a dosage of 45–55 mcg/kg/h with inhalation of Sevoflurane from 1 MAC. Endotracheal multicomponent anesthesia was performed in the control group. We used the Clavien-Dindo Classification of Complications, assessed the opioid consumption, the intensity of pain, the frequency of nausea and vomiting to objectively assess the postoperative results. Results. A lower incidence of early postoperative complications was observed in the main group – in 9 (15%) patients compared with the control group – 13 (21.7%) patients. The intensity of pain after surgery was less pronounced in the main group using carbohydrate loading and dalargin (p<0.05). There were also significant differences in the perioperative opioid consumption (p<0.05). The method used to manage patients in the main group allowed for a decrease in the incidence of postoperative nausea and vomiting (p<0.05). Conclusion. The use of stress protection methods with the inclusion of enkephalin dalargin and a preliminary carbohydrate load has a significant impact on the risk of postoperative complications after oropharyngeal surgery, increasing the effectiveness of therapeutic measures. Keywords: dalargin, anesthesia, surgery, cancer, oropharyngeal region, complications, stress protection Conflict of interest. The authors declare that they have no conflict of interest. Funding. This work was carried out within the framework of the TUSUR Development Program for 2025–2036 of the Strategic Academic Leadership Program «Priority 2030».