Department of Physiology and Pharmacology, Section of Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden.
Anesth Analg. 2011 Oct;113(4):778-83. doi: 10.1213/ANE.0b013e31821f950e. Epub 2011 May 19.
Surgery, general anesthesia, and related events have been implicated to promote cancer proliferation. We investigated the incidence of cancer within 5 years after surgery in relation to duration of anesthesia (T(ANESTH)) and also by time with bispectral index (BIS) under 45 (T(BIS<45)) serving as a proxy for more profound anesthesia exposure.
New malignant diagnoses after surgery under sevoflurane anesthesia were obtained in a prospective cohort of 2972 BIS-monitored patients without any clinically diagnosed malignant disease at the time of index surgery. The risk of cancer during follow-up in relation to T(ANESTH) and T(BIS<45) was assessed by Cox regression. The cancer incidence in this surgical population was compared with the incidence in a standardized general population by calculation of standard incidence ratio.
One hundred twenty-nine patients (4.3%) were assigned 136 new malignant diagnoses within 5 years after surgery. No relation between T(ANESTH) or T(BIS<45) and new malignant disease was found, nor were any significant relations obtained when other thresholds for BIS (i.e., <30, <40, and <50, respectively) were used in the calculations. The standard incidence ratio for new malignant disease was 1.37 (confidence interval, 1.15-1.62).
Neither duration of anesthesia nor increased cumulative time with profound sevoflurane anesthesia was associated with an increased risk for new malignant disease within 5 years after surgery in previously cancer-free patients.
手术、全身麻醉和相关事件已被认为可促进癌症增殖。我们研究了与麻醉持续时间（T（ANESTH））相关的手术后 5 年内癌症的发生率，以及双频谱指数（BIS）低于 45 时的时间（T（BIS<45））作为更深度麻醉暴露的替代指标。
在接受七氟醚麻醉的 2972 名接受 BIS 监测的患者的前瞻性队列中，获得了手术后新的恶性诊断，在索引手术时这些患者没有任何临床诊断的恶性疾病。通过 Cox 回归评估随访期间 T（ANESTH）和 T（BIS<45）与癌症风险的关系。通过计算标准发病率比，将该手术人群的癌症发病率与标准化一般人群的发病率进行比较。
129 例患者（4.3%）在手术后 5 年内被分配了 136 例新的恶性诊断。未发现 T（ANESTH）或 T（BIS<45）与新发恶性疾病之间存在任何关系，当使用其他 BIS 阈值（即分别<30、<40 和<50）进行计算时，也未获得任何显著关系。新发恶性疾病的标准发病率比为 1.37（置信区间，1.15-1.62）。
在先前无癌症的患者中，麻醉持续时间或深度七氟醚麻醉的累积时间增加均与手术后 5 年内新发恶性疾病的风险增加无关。
