Erschienen in:
01.12.2018 | Cancer Anesthesia (B Riedel and V Gottumukkala, Section
Editors)
Propofol (TIVA) Versus Volatile-Based Anesthetics: Is There Any
Oncological Benefit?
verfasst von:
Nicholas J. S. Perry, Timothy Wigmore
Erschienen in:
Current Anesthesiology Reports
|
Ausgabe 4/2018
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Abstract
Purpose of Review
To summarize the most recent available clinical and pre-clinical
research data concerning the effects of propofol-based total intravenous
anesthesia (TIVA) and volatile anesthesia on oncological outcomes and to discuss
the biological basis by which these drugs are purported to exert effects on the
cancer cell and on the host.
Recent Findings
Recent retrospective analyses of clinical datasets have generated
considerable interest in the hypothesis that the two major classes of general
anesthetics in clinical use for oncological surgery—namely inhalational fluranes
and intravenous propofol—disparately influence post-operative cancer outcomes.
There is also growing pre-clinical data to indicate that these drugs exert
distinct effects on cancer cell and immune cell phenotypes.
Summary
The available evidence tends to support the superiority of propofol
in terms of the effect on oncological outcomes, but there is a lack of
prospective data and a need to be mindful of the complexity and heterogeneity of
both the perioperative period and cancer as a disease when interpreting study
results and deciding future directions.