TY - JOUR
T1 - Potential influence of different peri-operative analgesic regimens on tumour biology and outcome after oncologic surgery
T2 - A narrative review
AU - Bezu, Lucillia
AU - Forget, Patrice
AU - Hollmann, Markus W.
AU - Parat, Marie Odile
AU - Piegeler, Tobias
N1 - Publisher Copyright:
© 2024 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - The management of peri-operative pain is one of the pillars of anaesthesia and is of particular importance in patients undergoing surgery for solid malignant tumours. Amongst several options, the most commonly employed analgesic regimens involve opioids, NSAIDs and regional anaesthesia techniques with different local anaesthetics. In recent years, several research reports have tried to establish a connection between peri-operative anaesthesia care and outcome after cancer surgery. Experimental studies have indicated that certain pain management substances may influence cancer progression, mainly by modifying the tumour's response to surgical stress and peri-operative inflammation. However, these promising in-vitro and in-vivo data have yet to be confirmed by randomised clinical trials. The reason for this might lie with the nature of tumour biology itself, and in the diversity of patient and tumour phenotypes. In a translational approach, future research should therefore concentrate on patient and tumour-related factors or biomarkers, which might either influence the tumour and its microenvironment or predict potential responses to interventions, including the choice of the analgesic. This might not only be relevant for the daily practice of clinical anaesthesia, but would also be of great importance for patients undergoing cancer surgery, who might be able to receive an individualised anaesthetic regimen based on their phenotypic profile.
AB - The management of peri-operative pain is one of the pillars of anaesthesia and is of particular importance in patients undergoing surgery for solid malignant tumours. Amongst several options, the most commonly employed analgesic regimens involve opioids, NSAIDs and regional anaesthesia techniques with different local anaesthetics. In recent years, several research reports have tried to establish a connection between peri-operative anaesthesia care and outcome after cancer surgery. Experimental studies have indicated that certain pain management substances may influence cancer progression, mainly by modifying the tumour's response to surgical stress and peri-operative inflammation. However, these promising in-vitro and in-vivo data have yet to be confirmed by randomised clinical trials. The reason for this might lie with the nature of tumour biology itself, and in the diversity of patient and tumour phenotypes. In a translational approach, future research should therefore concentrate on patient and tumour-related factors or biomarkers, which might either influence the tumour and its microenvironment or predict potential responses to interventions, including the choice of the analgesic. This might not only be relevant for the daily practice of clinical anaesthesia, but would also be of great importance for patients undergoing cancer surgery, who might be able to receive an individualised anaesthetic regimen based on their phenotypic profile.
UR - http://www.scopus.com/inward/record.url?scp=85214414149&partnerID=8YFLogxK
U2 - 10.1097/EJA.0000000000002118
DO - 10.1097/EJA.0000000000002118
M3 - Review article
C2 - 39743967
AN - SCOPUS:85214414149
SN - 0265-0215
VL - 42
SP - 233
EP - 243
JO - European Journal of Anaesthesiology
JF - European Journal of Anaesthesiology
IS - 3
ER -