2 research outputs found
UÄinak regionalne vs. opÄe anestezije na imuni odgovor u kirurgiji karcinoma dojke; pregled literature
For breast cancer patients, surgery remains the cornerstone in treatment. Perioperative
and postoperative period is associated with impaired immune function that can have profound
implications for cancer patients in terms of tumor recurrence and metastases. The three main factors
include surgery and related neuroendocrine stress response, anesthetic drugs, including opioid analgesics
and postoperative pain. The most investigated immune cells are natural killer (NK) cells that are
affected by both anesthesia and surgery. It has been demonstrated that ketamine, thiopental, volatile
anesthetics, fentanyl and morphine, but not propofol, remifentanil or tramadol reduce the number
of circulating NK cells and depress their toxicity. The level of NK cellsā cytotoxicity is inversely proportional
to the stage and spread of cancer. Regional anesthesia and its potential beneficial effects on
the perioperative immune response and long-term outcome after surgery has been investigated as an
alternative to general anesthesia in patients undergoing breast cancer surgery. In this paper, we present
a review of literature aimed to assess the impact of regional anesthesia techniques on the immune
response in patients undergoing breast cancer surgery and how it compares to general anesthesia.Za pacijente s rakom dojke operacija je neizostavni dio terapijskog postupka. Predoperativno i postoperativno razdoblje je
povezano s oslabljenom imunoloÅ”kom funkcijom koja može imati znaÄajne posljedice za bolesnike s karcinomom u smislu recidiva
tumora i metastaza. Tri su glavna Äimbenika odgovorna za takve promjene i ukljuÄuju operaciju i s njom povezan neuroendokrini
stresni odgovor, anestetike ukljuÄujuÄi opioidne analgetike i postoperativnu bol. NajÄeÅ”Äe istraživane imunoloÅ”ke stanice
su prirodne stanice ubojice (NK) na koje utjeÄu i anestezioloÅ”ki i kirurÅ”ki postupak. Pokazano je da ketamin, tiopental, hlapljivi
anestetici, fentanilimorfin, ali ne i propofol, remifentanil i tramadol, smanjuju broj cirkulirajuÄih NK stanica i njihovu citotoksiÄnost.
Razina citotoksiÄnosti NK stanica obrnuto je proporcionalna stadiju i proÅ”irenosti karcinoma. Regionalna anestezija
i njezin moguÄi povoljan uÄinak na predoperativni imunoloÅ”ki odgovor i dugoroÄni ishod nakon operacije istraživani su kao
alternativa opÄoj anesteziji u bolesnica koje su podvrgnute operaciji karcinoma dojke. Cilj ovog pregleda literature je procjena
utjecaja regionalne anestezije na imunoloŔki odgovor u pacijentica podvrgnutih operaciji karcinoma dojke te njezina usporedba
s opÄom anestezijom