[Perioperative pain control and mortality]

Abstract

Surgical stress response affects the neuroendocrine system and depresses the immune function. Anesthetic induction drugs (except propofol), volatile anesthetics and opioids also have an immunosupressive effect. Therefore, it is possible that the anesthetic drugs and methods may contribute to the recurrence of cancer after surgery. COX inhibitors prevent the opioid-induced tumor growth and metastasis, and regional anesthesia is expected to reduce the cancer recurrence via attenuating the surgical stress and reducing the amount of general anesthetics and opioids. Although some experimental studies and some clinical retrospective data show advantage of regional anesthesia over general anesthesia and opioid for postoperative analgesia, evidence level is still low and insufficient to prove its efficacy on postoperative mortality. Much more research and controlled clinical trials are needed to elucidate the advantage of the regional anesthesia in cancer operation.