Review article

Interactions between inhaled anesthetics and cytostatic agents

Gordana Brozović ; Department of Anesthesiology and ICU, University Hospital for tumors, Zagreb, Croatia
Nada Oršilić ; Department of Animal Physiology, Faculty of Science, University of Zagreb, Zagreb, Croatia
Fabijan Knežević ; Department of Pathology, University Hospital for tumors, Zagreb, Croatia
Anica Horvat-Knežević ; Department of Animal Physiology, Faculty of Science, University of Zagreb, Zagreb, Croatia
Katarina Šakić ; Department of Anesthesiology, Reanimatology and Intensive Medicine, Clinical Medical Center Zagreb, Zagreb, Croatia
Vesna Benković ; Department of Animal Physiology, Faculty of Science, University of Zagreb, Zagreb, Croatia
Danko Velimir Vrdoljak ; Department of Surgical Oncology, University Hospital for tumors, Zagreb, Croatia

Abstract

Inhaled anesthetics are often used for inducing or maintaining anesthesia in cancer patients as the length and complexity of the surgical procedure cannot be predicted for it depends on intraoperative surgical and pathohistological findings, and as often as not requires repeated operations for removal or reduction of the primary tumor, regional metastases, recurrence, pathological fractures, or surgery complications. These are easily volatile liquids that enter the body through inhalation, and then, by diffusion through the aleveolocapillary membrane, they are transferred into the blood stream to be transported to all other organs and the central nervous system. Most of the inhaled anesthetics are eliminated from the body through respiration; a portion of them, however, metabolizes in the liver via the cytochrome P450 oxidase family and is excreted via the kidneys, so the issue of their toxicity has always attracted a considerable interest from investigators. Cancer patients receiving cytostatic agents during the perioperative period increase in number every day. Aside from their planned surgery, cancer patients receiving cytostatics also undergo emergency surgery either for their disease complication or for another reason. It is important to understand the pharmacology of cytostatics, their interaction with anesthetics, pharmacokinetics and toxic reactions. Cytostatics and general anesthetics act immunosuppressively and thus compromise the patient’s immune status. In addition, cytostatics depress the myocardium and damage lung function, which can cause serious problems during anesthesia. Each anesthesia as well as each surgery produce stress on the body, and the anesthetics themselves alter the cell immunity so the patients receiving cytostatics during their perioperative period can experience serious general and organ-specific side effects. It would be worth knowing whether any of the most commonly used anesthetics today show an advantage in treating patients withcancer, especially patients receiving chemotherapy, and whether the inhaled anesthetics combined with cytostatics increase, enhance or even suppress the individual effect on various types of cells, above all on tumor cells that can become resistant to therapy for developing the so-called „multidrug resistance“.

Keywords

inhaled anesthetic agents; cytostatic agents; drug interaction

Hrčak ID:

281496

URI

https://hrcak.srce.hr/281496

Publication date:

7.12.2006.

Article data in other languages: croatian

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