RT Book, Section
A1 Durieux, Marcel E.
A2 Johnson, Ken B.
SR Print(0)
ID 1103964692
T1 Anesthetic Considerations in Cancer Patients
T2 Clinical Pharmacology for Anesthesiology
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071736169
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1103964692
RD 2023/03/25
AB Is  it  possible  that  particulars  of  perioperative  anesthetic  management  (eg,  using  epidural  local  anesthetics  during  general  anesthesia)  might  influence  long-term  recurrence  risk  after  cancer  surgery?  Not  too  long  ago,  this  would  have  been  considered  an  impossibility,  and  at  first  glance,  it  does  seem  an  unlikely  proposition.  How  could  a  change  in  management  during  a  procedure  that  lasts  at  most  several  hours  lead  to  effects  on  cancer  outcome  years  later?  Yet,  suggestive  (though  far  from  conclusive)  retrospective  clinical  data  indicate  that  there  might  be  an  effect,  and  even  a  significant  one.  Use  of  paravertebral  blocks1  or  the  addition  of  ketorolac2  in  breast  cancer,  or  the  addition  of  epidural  anesthesia  in  prostate3  or  colon  cancer4  might  reduce  risk  of  recurrence.  The  story  is  far  from  clear,  however,  as  other  studies5,6  do  not  indicate  benefit.  Prospective  randomized  trials  are  in  progress,  but  it  will  be  many  years  before  the  results  of  these  will  be  known.