Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
Anesth Analg. 2010 Jun 1;110(6):1636-43. doi: 10.1213/ANE.0b013e3181de0ab6. Epub 2010 Apr 30.
A wealth of basic science data supports the hypothesis that the surgical stress response increases the likelihood of cancer dissemination and metastasis during and after cancer surgery. Anesthetic management of the cancer patient, therefore, could potentially influence long-term outcome. Preclinical data suggest that beneficial approaches might include selection of induction drugs such as propofol, minimizing the use of volatile anesthetics, and coadministration of cyclooxygenase antagonists with systemic opioids. Retrospective clinical trials suggest that the addition of regional anesthesia might decrease recurrence after cancer surgery. Other factors such as blood transfusion, temperature regulation, and statin administration may also affect long-term outcome.
大量基础科学数据支持这样一种假说，即外科手术应激反应会增加癌症患者在癌症手术期间和之后发生癌症播散和转移的可能性。因此，癌症患者的麻醉管理可能会对长期预后产生影响。临床前数据表明，有益的方法可能包括选择异丙酚等诱导药物，尽量减少使用挥发性麻醉剂，以及将环氧化酶拮抗剂与全身阿片类药物联合使用。回顾性临床试验表明，区域麻醉的加入可能会降低癌症手术后的复发率。其他因素，如输血、体温调节和他汀类药物的应用，也可能影响长期预后。
