Pregledni rad
https://doi.org/10.20471/acc.2022.61.s2.15
The Effect of Regional vs. General Anesthesia on the Immune Response in Breast Cancer Surgery: Anarrative Review of the Literature
Vilena Vrbanović Mijatović
orcid.org/0000-0001-8568-1359
; Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Anesthesiology, Reanimatology and Surgical Intensive Care Medicine
Lucija Gatin
; Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia
Dinko Tonković
; Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Anesthesiology, Reanimatology and Surgical Intensive Care Medicine
Daniela Bandić Pavlović
; Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Anesthesiology, Reanimatology and Surgical Intensive Care Medicine
Sanda Smuđ Orehovec
; Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Surgery
Martina Miklić Bublić
; Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Zagreb, Zagreb, Croatia
Davor Mijatović
; Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Surgery
Sažetak
For breast cancer patients, surgery remains the cornerstone in treatment. Perioperative
and postoperative period is associated with impaired immune function that can have profound
implications for cancer patients in terms of tumor recurrence and metastases. The three main factors
include surgery and related neuroendocrine stress response, anesthetic drugs, including opioid analgesics
and postoperative pain. The most investigated immune cells are natural killer (NK) cells that are
affected by both anesthesia and surgery. It has been demonstrated that ketamine, thiopental, volatile
anesthetics, fentanyl and morphine, but not propofol, remifentanil or tramadol reduce the number
of circulating NK cells and depress their toxicity. The level of NK cells’ cytotoxicity is inversely proportional
to the stage and spread of cancer. Regional anesthesia and its potential beneficial effects on
the perioperative immune response and long-term outcome after surgery has been investigated as an
alternative to general anesthesia in patients undergoing breast cancer surgery. In this paper, we present
a review of literature aimed to assess the impact of regional anesthesia techniques on the immune
response in patients undergoing breast cancer surgery and how it compares to general anesthesia.
Ključne riječi
Breast Cancer Surgery; General Anesthesia; Regional Anesthesia; Immunosuppression; Immune Response
Hrčak ID:
284407
URI
Datum izdavanja:
1.9.2022.
Posjeta: 1.020 *