Opioids and immunosupression in oncological postoperative patients
José Luis Bonilla-García1, Manuel Cortiñas-Sáenz2, Esperanza Del Pozo-Gavilán3
1FEA Anestesiología y Reanimación, Complejo Hospitalario Universitario de Huelva, Huelva, Spain.
Revista Da Associacao Medica Brasileira (1992)
|December 15, 2017
Summary
Discontinuing remifentanil did not significantly alter the incidence of hospital-acquired infections (HAI) in cancer patients. This study suggests that the immunosuppression in cancer patients does not increase HAI risk after remifentanil interruption.
Area of Science:
- Anesthesiology
- Infectious Disease
- Oncology
Background:
- Opioid withdrawal may suppress the immune system, increasing infection risk.
- Investigating remifentanil discontinuation's effect on Post-Anesthesia Care Unit (PACU)-acquired infections is crucial.
Purpose of the Study:
- To assess the impact of remifentanil discontinuation on PACU-acquired infections in cancer patients.
- To determine if remifentanil cessation affects infection rates following prolonged sedation.
Main Methods:
- Retrospective study of 102 cancer patients receiving continuous remifentanil infusion for ≥96 hours.
- Comparative analysis of infection rates 6 days before and after remifentanil discontinuation.
- Exclusion of patients with combined analgesia or in-unit mortality.
Main Results:
- The incidence of PACU-acquired infections was 38 per 1,000 PACU days, with ventilator-associated pneumonia being most common.
- Pseudomonas aeruginosa was the predominant pathogen identified.
- No statistically significant difference in HAI incidence was observed after remifentanil discontinuation (p=0.068).
Conclusions:
- Cancer patients' baseline immunosuppression did not lead to increased HAI risk upon remifentanil interruption.
- Further multicenter studies incorporating immunological assessments are recommended to explore this relationship.
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