110843 20240319081001.0 doi 10.3389/fmed.2022.799355 sideral 127713 ART-2022-127713 eng Santander Ballestín, Sonia Universidad de Zaragoza (orcid)0000-0002-1275-2600 Antitumor Anesthetic Strategy in the Perioperatory Period of the Oncological Patient: A Review 2022 Access copy available to the general public Unrestricted The stress response triggered by the surgical aggression and the transient immunosuppression produced by anesthetic agents stimulate the inadvertent dispersion of neoplastic cells and, paradoxically, tumor progression during the perioperative period. Anesthetic agents and techniques, in relation to metastatic development, are investigated for their impact on long-term survival. Scientific evidence indicates that inhaled anesthetics and opioids benefit immunosuppression, cell proliferation, and angiogenesis, providing the ideal microenvironment for tumor progression. The likely benefit of reducing their use, or even replacing them as much as possible with anesthetic techniques that protect patients from the metastatic process, is still being investigated. The possibility of using “immunoprotective” or “antitumor” anesthetic techniques would represent a turning point in clinical practice. Through understanding of pharmacological mechanisms of anesthetics and their effects on tumor cells, new perioperative approaches emerge with the aim of halting and controlling metastatic development. Epidural anesthesia and propofol have been shown to maintain immune activity and reduce catecholaminergic and inflammatory responses, considering the protective techniques against tumor spread. The current data generate hypotheses about the influence of anesthesia on metastatic development, although prospective trials that determinate causality are necessary to make changes in clinical practice. info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 3.9 2022 MEDICINE, GENERAL & INTERNAL 58 / 169 = 0.343 2022 Q2 T2 0.926 2022 Medicine (miscellaneous) 2022 Q1 3.6 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Lanuza Bardaji, Andrea Marco Continente, Cristina Luesma Bartolomé, María José Universidad de Zaragoza (orcid)0000-0003-4071-1467 1003 027 Universidad de Zaragoza Dpto. Anatom.Histolog.Humanas Area Anatom.Embriol.Humana 1012 315 Universidad de Zaragoza Dpto. Farmac.Fisiol.y Med.L.F. Área Farmacología 9 (2022), 799355 [16 pp] Front. med. Frontiers in Medicine 2296-858X 1058825 http://zaguan.unizar.es/record/110843/files/texto_completo.pdf Versión publicada 2337238 http://zaguan.unizar.es/record/110843/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:110843 articulos driver 2024-03-18-14:12:15 ARTICLE