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优化癌症患者的区域麻醉:当前实践与未来方向的全面综述

Optimizing Regional Anesthesia for Cancer Patients: A Comprehensive Review of Current Practices and Future Directions.

作者信息

Bhuyan Shyamolima, Bhuyan Deepjit, Rahane Shubham

机构信息

Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Sep 13;16(9):e69315. doi: 10.7759/cureus.69315. eCollection 2024 Sep.

Abstract

Regional anesthesia has emerged as a pivotal component in the perioperative management of cancer patients, offering several advantages over traditional general anesthesia. By providing targeted pain relief and minimizing systemic exposure to opioids, regional anesthesia reduces the risk of opioid-related side effects and enhances postoperative recovery. Regional anesthesia may positively influence oncological outcomes by attenuating the surgical stress response and preserving immune function, potentially reducing cancer recurrence and metastasis. This review comprehensively explores the current practices and benefits of regional anesthesia in the oncology setting, including various techniques such as nerve blocks, epidural anesthesia, and spinal anesthesia. It examines the challenges associated with its application in cancer patients, including technical difficulties and patient-related factors. It evaluates the existing evidence regarding its impact on cancer progression and patient survival. Additionally, the review discusses future directions in the field, emphasizing the need for personalized anesthesia strategies, further research into the long-term effects of regional anesthesia on cancer outcomes, and the development of innovative approaches to enhance its efficacy and safety. By addressing these areas, this review aims to provide a thorough understanding of how to optimize regional anesthesia for cancer patients, ultimately contributing to improved perioperative care and better long-term outcomes.

摘要

区域麻醉已成为癌症患者围手术期管理的关键组成部分,相较于传统全身麻醉具有诸多优势。通过提供针对性的疼痛缓解并减少全身对阿片类药物的暴露,区域麻醉降低了阿片类药物相关副作用的风险,并促进术后恢复。区域麻醉可能通过减轻手术应激反应和维持免疫功能对肿瘤学结局产生积极影响,从而有可能降低癌症复发和转移的风险。本综述全面探讨了区域麻醉在肿瘤学领域的当前实践和益处,包括神经阻滞、硬膜外麻醉和脊髓麻醉等各种技术。它审视了在癌症患者中应用区域麻醉所面临的挑战,包括技术难题和与患者相关的因素。它评估了关于其对癌症进展和患者生存影响的现有证据。此外,该综述讨论了该领域的未来方向,强调需要个性化麻醉策略,进一步研究区域麻醉对癌症结局的长期影响,以及开发创新方法以提高其有效性和安全性。通过探讨这些领域,本综述旨在全面了解如何为癌症患者优化区域麻醉,最终有助于改善围手术期护理并取得更好的长期结局。

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