RT Journal Article
SR Electronic
T1 Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 13
OP 28
DO 10.1136/rapm-2018-000001
VO 44
IS 1
A1 Andres Missair
A1 Juan Pablo Cata
A1 Gina Votta-Velis
A1 Mark Johnson
A1 Alain Borgeat
A1 Mohammed Tiouririne
A1 Vijay Gottumukkala
A1 Donal Buggy
A1 Ricardo Vallejo
A1 Esther Benedetti de Marrero
A1 Dan Sessler
A1 Marc A Huntoon
A1 Jose De Andres
A1 Oscar De Leon Casasola
YR 2019
UL http://rapm.bmj.com/content/44/1/13.abstract
AB 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.