麻醉技术和癌症结果:目前的证据是什么?
Mohd S Ramly1, Donal J Buggy1,2,3
1From the Department of Anesthesiology & Perioperative Medicine, Mater Misericordiae University Hospital, School of Medicine, University College Dublin, Dublin, Ireland.
Anesthesia and analgesia
|October 28, 2024
概括
麻醉技术可能会影响癌症生物学,但目前的临床试验显示,它对长期癌症结果具有中性影响. 对于癌症患者,建议对外科手术期间的药物和多学科护理进行进一步研究.
科学领域:
- 麻醉学 麻醉学
- 在瘤学瘤学.
- 癌症生物学 癌症生物学
背景情况:
- 近20年前提出了一个假设,即麻醉可能会调节癌症生物学和患者的结果.
- 研究重点是麻醉剂对癌症细胞生物学影响的药理和生理基础.
- 本综述综合了目前关于麻醉对癌症影响的实验室和临床数据.
研究的目的:
- 审查和总结现有的实验室和临床证据,关于麻醉技术对癌症生物学和患者结果的影响.
- 评估当前对麻醉和外科手术干预如何影响癌细胞功能的理解.
- 确定未来研究和合作领域,以优化癌症患者的术后护理.
主要方法:
- 审查临床前 (实验室) 研究,调查麻醉对癌细胞影响的生物可信性.
- 分析临床数据,包括观察性研究和前性随机临床试验 (RCT),检查手术后的癌症结果.
- 综合各种癌症类型和麻醉技术的证据.
主要成果:
- 临床前研究表明,麻醉影响癌细胞功能的生物基础.
- 临床证据,特别是来自RCT的临床证据,通常表明麻醉技术对长期瘤结果的中性影响.
- 一个例外是乳腺癌手术中的周围门利多卡因透,这已经显示出潜在的益处.
结论:
- 虽然临床前数据表明存在潜在影响,但目前的临床证据主要支持麻醉技术对长期癌症结果的中性影响.
- 未来的随机临床试验 (RCT) 是至关重要的,但由于所需的患者数量和随访时间而具有挑战性.
- 未来的研究应该探索术后药剂与瘤基因的相互作用,多学科合作对于优化癌症患者护理至关重要.
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