Loco-regional analgesia in oncology. Influence on cancer recurrence rate. Literature review.
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Pathology. Clinical medicine (6964)
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BALTAGA, Ruslan, PERCIUN, Andrei, BADAN, Andrei, TURCHIN, Radu, COTELEA, Valeria. Loco-regional analgesia in oncology. Influence on cancer recurrence rate. Literature review.. In: Revista de Ştiinţe ale Sănătăţii din Moldova, 2023, vol. 10, nr. 1, pp. 82-89. ISSN 2345-1467. DOI: https://doi.org/10.52645/MJHS.2023.1.12
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Revista de Ştiinţe ale Sănătăţii din Moldova
Volumul 10, Numărul 1 / 2023 / ISSN 2345-1467

Loco-regional analgesia in oncology. Influence on cancer recurrence rate. Literature review.

DOI:https://doi.org/10.52645/MJHS.2023.1.12
CZU: 616-006.6-009.624

Pag. 82-89

Baltaga Ruslan12, Perciun Andrei3, Badan Andrei2, Turchin Radu12, Cotelea Valeria21
 
1 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
2 Institute of Oncology,
3 Queen Alexandra Hospital
 
 
Disponibil în IBN: 25 aprilie 2023


Rezumat

Introduction. A major role and, at the same time, a question mark, both for patients and doctors, is the possibility that drugs and anesthetic techniques influence cancer metastasis. Cancer is the leading cause of death worldwide. This trend will continue in the future. Most of the deaths of cancer patients are due to complications arising from metastases. The metastasis process of a tumor depends on its intrinsic properties and interaction with the host. The treatment of tumors by performing a surgical intervention, radical or palliative, has a significant impact. For these reasons, the rate of survival and migration of cancer cells in the perioperative period is studied quite insistently and complexly. Thus, surgical intervention and anesthetic support in cancer patients becomes of great importance, because it represents the vulnerable link, both from the point of view of the operation itself, as well as the possibility that drugs, anesthetic techniques may or may not influence tumor metastasis. Material and methods. Primary scientific studies published from 1996 to 2021 dedicated to loco-regional anesthesia and its influence on the perioperative period and on cancer metastasis were studied. To achieve the proposed goal, scientific sources PubMed, Medscape, SCOPUS, MEDLINE were researched. Keywords used for searching: loco-regional anesthesia, fascia plane anesthesia, metastasis. More than 80 reference sources were identified, 67 were selected for analysis. Results and discussions. The surgical procedure, itself, performed for curative purposes, also known as tumor resection – is a risk factor for metastasis by creating an environment with high potential for tumor cell survival. This stimulates tumor growth and angiogenesis, can remodel lymphatic pathways, allowing metastasis of tumor cells. Hemotransfusion is associated with increased risk of metastasis. Regional anesthesia could reduce cancer recurrence through several mechanisms. Conclusions. Regional anesthesia could reduce cancer recurrence by reducing the need for opioids or inhaled anesthetics, or by reducing the stress response during surgery. There is scientific in vitro evidence of a protective effect of systemic lidocaine on recurrent cancer, although relevant clinical data are limited.

Cuvinte-cheie
cancer recurrence, general anesthesia, regional anesthesia, stress response, opioid analgesics, angiogenesis inducing agents, morphine, onco-anesthesia