Anesthesia Management to Improve Outcomes

Abstract

Neoplastic pathology is the second cause of death in developed countries. In our specialty, there is great concern about the implications of the anesthetic technique and the drugs used, present in the perioperative period of the cancer patient; as well as other perioperative factors. Among the latter, we highlight the management of psychological stress, adequate pain control, the type of surgery, avoiding hypothermia, and reducing transfusions of blood products. This concern is based on the fact that despite great advances in both surgical techniques for tumor resection and neoadjuvant and adjuvant polychemotherapy techniques; tumor recurrence rates have not decreased as desired. This suggests that the previously mentioned perioperative factors play an active role in tumor recurrence in cancer patients. Based on current evidence and our experience, we can affirm that the use of anesthetic/analgesic techniques based on the use of propofol, NSAIDs, and regional anesthesia with local anesthetics that achieve a decrease in the perioperative consumption of opiates, especially morphine, can be beneficial to protect the anti-metastatic immune response of the organism in a period of special protumoral susceptibility such as the perioperative period.