Volatiles vs. TIVA – Is there a difference in cancer patients

IF 2.8 3区 医学 Q1 ANESTHESIOLOGY
Bente FH. Dubois, Markus W. Hollmann
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引用次数: 0

Abstract

Cancer incidence continues to rise, with 20 million new cases and 9.7 million cancer-related deaths reported in 2022. With the vast majority of these patients requiring anaesthesia. However, despite surgical resection, nearly one-third of patients experience local recurrence or distant metastases. Perioperative factors, including surgical stress and anaesthetic technique, may influence recurrence, though tumour biology remains not fully understood.
The impact of total intravenous anaesthesia (TIVA) versus inhalation anaesthesia (IA) on oncological outcomes has attracted growing interest. While some studies suggest a potential advantage of propofol-based TIVA, the probability of a clinically significant effect remains low. The existing literature consists mainly of retrospective studies and small randomised trials (RCT's) with methodological limitations.
Currently, there is no strong evidence that TIVA or IA has a meaningful impact on cancer-free survival. This review critically examines the available research and presents an alternative perspective on this controversial topic.
挥发物与TIVA -在癌症患者中有区别吗
癌症发病率继续上升,2022年报告有2000万新病例和970万癌症相关死亡。绝大多数病人需要麻醉。然而,尽管手术切除,近三分之一的患者出现局部复发或远处转移。围手术期因素,包括手术压力和麻醉技术,可能影响复发,尽管肿瘤生物学仍未完全了解。全静脉麻醉(TIVA)与吸入麻醉(IA)对肿瘤预后的影响引起了越来越多的关注。虽然一些研究表明基于异丙酚的TIVA具有潜在的优势,但临床显著效果的可能性仍然很低。现有文献主要包括回顾性研究和小型随机试验(RCT’s),方法上存在局限性。目前,没有强有力的证据表明TIVA或IA对无癌生存有意义的影响。这篇综述批判性地考察了现有的研究,并提出了对这一有争议的话题的另一种观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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36 days
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