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Current Understanding on Perioperative Management in Lung Cancer: Implications for Anesthetic Considerations

Authors Wang J, Liu L, Song Y, Jiao J, Zhong Y

Received 13 December 2020

Accepted for publication 10 February 2021

Published 25 February 2021 Volume 2021:15 Pages 835—842

DOI https://doi.org/10.2147/DDDT.S297200

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Qiongyu Guo


Jian Wang,1 Lei Liu,2 Yuli Song,3 Jinghua Jiao,4 Yifan Zhong2

1Department of Anesthesiology, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of China; 2Department of Ophthalmology, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of China; 3Department of Gynaecology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of China; 4Department of Anesthesiology, Central Hospital, Shenyang Medical College, Shenyang, 110024, People’s Republic of China

Correspondence: Jinghua Jiao
Department of Anesthesiology, Central Hospital, Shenyang Medical College, Shenyang, 110024, People’s Republic of China
Email [email protected]
Yifan Zhong
Department of Ophthalmology, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of China
Email [email protected]

Abstract: Narcotic drugs are often used to treat perioperative pain for patients with lung cancer. However, anesthetic management and narcotic substance use may have significant impacts on patients with lung cancer, including anti-cancer or promoting cancer effects. In this study, we summarize the effects of anesthetic management and its related substances on lung cancer. An evidence-based review of the influence of anesthetic techniques and narcotic substances used on lung cancer was performed. The effects of perioperative pain management and the method of choosing anesthesia for patients with lung cancer were explored. Different management techniques of anesthesia have been indicated to suppress both cell-mediated immunity and humoral immunity and have effects on the recurrence and metastasis of lung cancer. Evidence suggests that the effects of narcotic substances used on lung cancer were still inconsistent. However, the mechanisms by which anesthetics and analgesics inhibit the tumor are complicated. Perioperative management leads to decreased immunity in patients with lung cancer, which to some extent contributes to recurrence and metastasis. Various narcotic substances used may modulate signal pathways, including the mitochondrial pathway, and appear to exert different effects on the recurrence and metastasis of lung cancer. The anesthesiologists should consider these effects on perioperative management with lung cancer.

Keywords: narcotic substance use, anesthetics, lung cancer

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