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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
460
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

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Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
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Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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The Influence of Analgesic Modalities on Postoperative Cancer Recurrence.

Amber N Edinoff1, Olivia C Derise2, Aaron J Sheppard2

  • 1Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, LA, USA.

Anesthesiology and Pain Medicine
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Certain anesthetics and opioids may promote cancer spread, while propofol and COX inhibitors show potential in reducing recurrence. Understanding these influences is key for better cancer patient outcomes.

Keywords:
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Area of Science:

  • Oncology
  • Immunology
  • Anesthesiology

Background:

  • Cancer growth and metastasis involve complex interactions between inflammation, immune cells, and stromal tissue.
  • Cancer recurrence risk is influenced by various factors including immunology, lifestyle, genetics, and patient demographics.
  • Opioids are commonly used for pain management in cancer patients, but their impact on cancer progression is a concern.

Purpose of the Study:

  • To investigate the influence of different anesthetic agents and analgesics on cancer recurrence and metastasis.
  • To evaluate the potential of certain drugs to either promote or inhibit cancer propagation.
  • To identify anesthetic and analgesic strategies that may improve cancer-free and overall survival.

Main Methods:

  • Review of existing literature and meta-analyses on the effects of anesthetics and opioids on cancer.
  • Analysis of how specific agents like morphine, fentanyl, propofol, and COX inhibitors affect immune cells (e.g., T regulatory cells, NK cells, CD8+ cytotoxic T-cells) and tumor growth.
  • Examination of the impact on cancer-free survival and overall survival.

Main Results:

  • Inhaled anesthesia and certain opioids (morphine, fentanyl) may create a pro-tumor metastasis environment.
  • Opioids can modulate immune responses, e.g., increasing T regulatory cells and suppressing NK and CD8+ T-cells.
  • Propofol-based anesthesia and COX inhibitors (ketorolac, celecoxib) show promise in preserving immune function and potentially reducing cancer recurrence.

Conclusions:

  • Anesthetic and analgesic choices significantly impact cancer recurrence and metastasis.
  • Propofol and COX inhibitors represent potential alternatives to mitigate the pro-tumorigenic effects of traditional agents.
  • Further research into optimizing perioperative care is crucial for improving long-term cancer patient outcomes.