Immunological Insights into Opioid-Free Anaesthesia in Oncological Surgery: A Scoping Review.

Laura Smith, Juan P Cata, Patrice Forget

Journal: Current oncology reports 2022;24(10):1327-1336

PMID: 35633449

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Abstract

PURPOSE OF REVIEW

The influence of opioids on outcomes after cancer surgery when used, or avoided, intraoperatively remains unclear. There is a need to conduct a scoping review to explore the wider context and provide direction for future research. The review will examine the current state of evidence in humans, with a focus on immunological biomarkers and clinically relevant cancer outcomes in trials comparing opioid-free to opioid-based general anaesthesia.

RECENT FINDINGS

There is limited research on this subject area, which is mainly focused on breast cancer. The most frequently evaluated immunological parameter is the neutrophil-to-lymphocyte ratio. Cancer outcomes are mainly focused on recurrence. The central knowledge gap is understanding how the cellular effects of opioids translate into longer-term patient outcomes. The major challenge for future research is accounting for the immunomodulatory effects of a wide range of confounding factors, which have yet to be clarified.

Address: School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK. [email protected].; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Anaesthesiology and Surgical Oncology Research Group, Houston, TX, USA.; Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.; Department of Anaesthesia, NHS Grampian, Aberdeen, UK.

DOI: 10.1007/s11912-022-01300-5