Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article

Cancer causes considerable suffering and 80% of advanced cancer patients experience moderate to severe pain. Surgical tumor excision remains a cornerstone of primary cancer treatment, but is also recognized as one of the greatest risk factors for metastatic spread. The perioperative period, characte...

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Bibliographic Details
Published inRegional anesthesia and pain medicine Vol. 44; no. 1; pp. 13 - 28
Main Authors Missair, Andres, Cata, Juan Pablo, Votta-Velis, Gina, Johnson, Mark, Borgeat, Alain, Tiouririne, Mohammed, Gottumukkala, Vijay, Buggy, Donal, Vallejo, Ricardo, Marrero, Esther Benedetti de, Sessler, Dan, Huntoon, Marc A, Andres, Jose De, Casasola, Oscar De Leon
Format Journal Article
LanguageEnglish
Published England Copyright by American Society of Regional Anesthesia and Pain Medicine 01.01.2019
BMJ Publishing Group LTD
Subjects
Analgesics
Analgesics - administration & dosage
Anesthesia
Cancer Pain - surgery
Cancer Pain - therapy
Cancer surgery
Carcinogenesis - drug effects
Carcinogenesis - pathology
Clinical medicine
Disease Progression
Drug dosages
Humans
Metastasis
Narcotics
Neoplasm Recurrence, Local - surgery
Neoplasm Recurrence, Local - therapy
Pain management
Pain Management - methods
Pain Management - trends
Perioperative care
Perioperative Care - methods
Perioperative Care - trends
Ratings & rankings
Regional anesthesia
Tumors
United States > US
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Summary:Cancer causes considerable suffering and 80% of advanced cancer patients experience moderate to severe pain. Surgical tumor excision remains a cornerstone of primary cancer treatment, but is also recognized as one of the greatest risk factors for metastatic spread. The perioperative period, characterized by the surgical stress response, pharmacologic-induced angiogenesis, and immunomodulation results in a physiologic environment that supports tumor spread and distant reimplantation.In the perioperative period, anesthesiologists may have a brief and uniquewindow of opportunity to modulate the unwanted consequences of the stressresponse on the immune system and minimize residual disease. This reviewdiscusses the current research on analgesic therapies and their impact ondisease progression, followed by an evidence-based evaluation of perioperativepain interventions and medications.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
content type line 23
ObjectType-Review-1
ISSN:1098-7339
1532-8651
DOI:10.1136/rapm-2018-000001