Effect of Anaesthesia Technique on anti-tumor Immunity through TGF-β levels in Adult Patients Undergoing Surgery for Oral Cancer.

BACKGROUND

There is a paucity of literature regarding the effect of anesthetic techniques on anti-tumor immunity, especially in Oral cavity Malignancies. We designed a study to evaluate the effect of 3 anesthetic techniques - Opioid, Lignocaine infusion and Dexmeditomedine infusion-based on anti-tumor immunity, using TGF-β, T-helper cell profile and inflammatory markers such as IL-6 and IL-10.

METHODS

A pilot prospective randomized trial was conducted in 90 patients undergoing surgery for Oral cavity malignancy under general anesthesia in a tertiary specialty cancer hospital. Adult cancer patients of the American Society of Anaesthesiologists (ASA) physical status I-III fulfilling the inclusion criteria were randomized to either group A (Opioid general anesthesia), group B (lignocaine infusion-based general anesthesia), or group C (Dexmedetomidine infusion-based general anesthesia). Preoperative (morning of surgery) and postoperative (24 hours after surgery) blood samples were obtained. Statistical analysis was done, and the results were analyzed.

RESULTS

Demographic profile and pre-operative parameters were comparable between both groups. We did not find any statistically significant difference in the Post-operative levels of TGF-β, neutrophil-lymphocyte ratio (NLR), Monocyte Lymphocyte Ratio (MLR), platelet lymphocyte ratio (PLR), IL-6, IL-10, and T-helper cell profile( IFN-γ, IL-17A, and IL-4 as surrogate markers) among the three study groups. However, it was noted that the overall Opioid consumption was markedly reduced in Group C without any major adverse effects being noted.