Outcomes of cancer surgery after inhalational and intravenous anesthesia: A systematic review

Soltanizadeh, Sinor; Degett, Thea Helene; Gögenur, Ismail

doi:10.1016/j.jclinane.2017.08.001

Cited by 81 publications

(60 citation statements)

References 37 publications

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“…(25) Numerous studies have assessed the effects of anesthetics on mortality after various types of cancer surgeries. (26)(27)(28)(29). Although large randomized controlled trials are still required, a signi cant difference in the risk of mortality according to the anesthetic used in patients undergoing cancer surgery has been reported by previous studies.…”

Section: Discussionmentioning

confidence: 98%

“…Although large randomized controlled trials are still required, a signi cant difference in the risk of mortality according to the anesthetic used in patients undergoing cancer surgery has been reported by previous studies. (26)(27)(28) Against this background, it seems clear that, to optimize outcomes, the choice of anesthetic should be based on the characteristics of the individual case rather than the anesthesiologist's discretion. However, the literature on this topic is currently insu cient.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Propofol- and Inhalant-Based Anesthesia on Acute Kidney Injury After Major Abdominal Surgery: A Retrospective Observational Study

Kim¹,

Yoon²,

Song³

et al. 2020

Preprint

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Abstract Background: The optimal anesthetic for preventing postoperative acute kidney injury (AKI) remains unclear, and few studies on this topic have been conducted in the context of non-cardiac surgery. The purpose of this retrospective study was to compare propofol- and inhalant-based anesthesia in terms of the risk of AKI after open major abdominal surgery (MAS).Methods: Adult patients who underwent open MAS (gastrectomy, hepatectomy, colectomy, or pancreatectomy) at our institute from January 2016 to December 2018 were included. Using multivariable logistic regression, the risk of postoperative AKI was compared between patients who underwent propofol-based anesthesia (propofol group) and those who received inhalant-based anesthesia (inhalant group). Additional logistic regression analyses were performed after propensity score matching and inverse probability of treatment weighting (IPTW).Results: In total, 3,616 patients were analyzed. The incidence of postoperative AKI was 5.0% (77/1546) and 7.8% (161/2070) in the propofol and inhalant groups, respectively. The risk of AKI was significantly higher in the inhalant group (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.23–2.30; P= 0.001) than the propofol group. In the propensity score-matched cohort, the inhalant group had a higher risk of AKI than the propofol group (aOR, 1.68; 95% CI, 1.21–2.34; P= 0.002), and the logistic regression with IPTW showed similar results (OR, 1.74; 95% CI 1.14–1.66; P< 0.001).Conclusion: The risk of AKI after open MAS may differ significantly according to the anesthetic used. Patients receiving inhalant-based anesthesia may have a greater risk of postoperative AKI than those anaesthetized with propofol.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

The Impact of Propofol- and Inhalant-Based Anesthesia on Acute Kidney Injury After Major Abdominal Surgery: A Retrospective Observational Study

Kim¹,

Yoon²,

Song³

et al. 2020

Preprint

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“…It has been reported that propofol exhibits better immunomodulatory properties than volatile anesthetics [20][21][22]. Some studies have shown that survival rates after cancer surgery are better for patients who receive TIVA than for those who receive VIA [9,10,23,24]. After matching, postoperative survival was investigated in 1158 patients with colon cancer [11]; the propofol-treated group had better survival (189 deaths, 32.6%, in the desflurane group vs. 87, 15.0%, in the propofol group).…”

Section: Discussionmentioning

confidence: 99%

Anesthetics and long-term survival after cancer surgery—total intravenous versus volatile anesthesia: a retrospective study

Hong

Lee

Kim

et al. 2019

Preprint

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Background: Intravenous anesthesia has been reported to have a favorable effect on the prognosis of cancer patients. This study was performed to analyze data regarding the relation between anesthetics and the prognosis of cancer patients in our hospital. Methods: The medical records of patients who underwent surgical resection for gastric, lung, liver, colon, and breast cancer between January 2006 and December 2009 were reviewed. Depending on the type of anesthetic, it was divided into total intravenous anesthesia (TIVA) or volatile inhaled anesthesia (VIA) group. The 5-year overall survival outcomes were analyzed by log-rank test. Cox proportional hazards modeling was used for sensitivity. Results: The number of patients finally included in the comparison after propensity matching came to 729 in each group. The number of surviving patients at 5 years came to 660 (90.5%) in the TIVA and 673 (92.3%) in the VIA. The type of anesthetic did not affect the 5-year survival rate according to the log-rank test (P = 0.21). Variables associated with a significant increase in the hazard of death after multivariable analysis were male sex and metastasis at surgery. Conclusions: There were no differences in 5-year overall survival between two groups in the cancer surgery.

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“…However, these evidences are limited to small and low-quality studies, deeming necessary further proper designed randomized controlled trials. 58 Another systematic review and meta-analysis, very recently published by Yap et al examine the potential effects of anesthetic strategies for cancer surgery on survival. 59 Compared to volatile anesthesia, total intravenous anesthesia was characterized by lower mortality in patients with gastric .…”

Section: Current Evidence On the Effects Of Anesthesia On Short And Lmentioning

confidence: 99%

<p>Anesthetic Strategies in Oncological Surgery: Not Only a Simple Sleep, but Also Impact on Immunosuppression and Cancer Recurrence</p>

Longhini¹,

Bruni²,

Garofalo³

et al. 2020

CMAR

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Tumor recurrences or metastases remain a major hurdle in improving overall cancer survival. In the perioperative period, the balance between the ability of the cancer to seed and grow at the metastatic site and the ability of the patient to fight against the tumor (i.e. the host antitumor immunity) may determine the development of clinically evident metastases and influence the patient outcome. Up to 80% of oncological patients receive anesthesia and/or analgesia for diagnostic, therapeutic or palliative interventions. Therefore, anesthesiologists are asked to administer drugs such as opiates and volatile or intravenous anesthetics, which may determine different effects on immunomodulation and cancer recurrence. For instance, some studies suggest that intravenous drugs, such as propofol, may inhibit the host immunity to a lower extent as compared to volatile anesthetics. Similarly, some studies suggest that analgesia assured by local anesthetics may provide a reduction of cancer recurrence rate; whilst on the opposite side, opioids may exert negative consequences in patients undergoing cancer surgery, by interacting with the immune system response via the modulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, or directly through the opioid receptors on the surface of immune cells. In this review, we summarize the main findings on the effects induced by different drugs on immunomodulation and cancer recurrence.

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Outcomes of cancer surgery after inhalational and intravenous anesthesia: A systematic review

Cited by 81 publications

References 37 publications

The Impact of Propofol- and Inhalant-Based Anesthesia on Acute Kidney Injury After Major Abdominal Surgery: A Retrospective Observational Study

The Impact of Propofol- and Inhalant-Based Anesthesia on Acute Kidney Injury After Major Abdominal Surgery: A Retrospective Observational Study

Anesthetics and long-term survival after cancer surgery—total intravenous versus volatile anesthesia: a retrospective study

<p>Anesthetic Strategies in Oncological Surgery: Not Only a Simple Sleep, but Also Impact on Immunosuppression and Cancer Recurrence</p>

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