Department of Anesthesiology, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China.
Department of Surgery, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China.
Drug Des Devel Ther. 2022 Apr 20;16:1121-1129. doi: 10.2147/DDDT.S356863. eCollection 2022.
Cancer is the second leading cause of death following ischemic heart disease in the world and the primary clinical, social and economic burden. Surgical resection is the main measure for the treatment of the vast majority of solid tumors. However, the recurrence and metastasis of tumors occur at different periods after surgery in many cases undergoing radical tumor surgery, which is the main cause of death of tumor patients. Moreover, tumor patients are prone to suffer from mental depression, which may increase the morbidity and mortality of tumors. Tumors have a series of clinical biological signs with the following five main features: postoperative pain and cancerous pain; suppression of antitumor immunity; angiogenesis in tumors; proliferation, growth and metastasis of tumors; and mental depression. Surgery is the first treatment in the majority of cancer patients with solid tumors. Opioids are required for anesthesia and postoperative analgesia. For cancerous pain control, patients undergo surgery, and their quality of life of is improved. However, traditional opioids, such as morphine, may inhibit antitumor immunity, induce vascular growth of tumors and promote the proliferation, invasion and migration of cancer cells, and traditional opioids can induce a risk of somatic dependence. However, studies have found that not all opioids share the effects of immunosuppression, tumor proliferation promotion and angiogenesis induction. Dezocine, a novel opioid with specific pharmacological mechanisms, has been demonstrated to regulate the five clinical and biological features of tumors. We reviewed the preclinical and clinical studies of dezocine on postoperative pain and cancer pain in tumor patients as well as the immune system, tumor angiogenesis, tumor proliferation, tumor growth, tumor metastasis and mental depression. We proposed that dezocine may be the best choice of opioids for anesthesia and analgesia in cancer patients.
癌症是全球仅次于缺血性心脏病的第二大致死原因，也是主要的临床、社会和经济负担。手术切除是治疗绝大多数实体瘤的主要手段。然而，在许多接受根治性肿瘤手术的患者中，肿瘤在手术后的不同时期会复发和转移，这是肿瘤患者死亡的主要原因。此外，肿瘤患者容易患有精神抑郁，这可能会增加肿瘤的发病率和死亡率。肿瘤具有一系列临床生物学特征，主要有以下五个特征：术后疼痛和癌性疼痛；抑制抗肿瘤免疫；肿瘤血管生成；肿瘤的增殖、生长和转移；以及精神抑郁。手术是大多数实体瘤癌症患者的首选治疗方法。麻醉和术后镇痛需要使用阿片类药物。为了控制癌性疼痛，患者接受手术，其生活质量得到改善。然而，传统的阿片类药物，如吗啡，可能会抑制抗肿瘤免疫，诱导肿瘤血管生长，并促进癌细胞的增殖、侵袭和迁移，传统的阿片类药物可能会引起躯体依赖的风险。然而，研究发现并非所有阿片类药物都具有免疫抑制、肿瘤增殖促进和血管生成诱导的作用。地佐辛是一种具有特定药理机制的新型阿片类药物，已被证明可以调节肿瘤的五个临床和生物学特征。我们回顾了地佐辛在肿瘤患者术后疼痛和癌痛以及免疫系统、肿瘤血管生成、肿瘤增殖、肿瘤生长、肿瘤转移和精神抑郁方面的临床前和临床研究。我们提出地佐辛可能是癌症患者麻醉和镇痛的最佳阿片类药物选择。
