Table 4.
Randomized controlled trials assessing local anesthetics impact on cancer prognosis.
| Cancer | Patients | Design | Cancer prognosis outcome | Ref |
|---|---|---|---|---|
| Bladder | N=150 | Control group: general anesthesia (sevoflurane)+fentanyl | Local anesthesia: longer disease-free survival (p=0.02) | (119) |
| Postoperative (morphine) | ||||
| N=510 | Studied group (propofol) +lidocaine+ epidural (ropivacaine) | |||
| Breast | N=11 | Control group: general anesthesia (sevoflurane) + morphine postoperative: PCA (morphine) | Patient serum from studied group reduced MDA-MB-231 breast carcinoma cell proliferation (p=0.01) | (121) |
| N=11 | Studied group: general anesthesia (propofol) + PVB (bolus and infusion of levobupivacaine) | |||
| Breast | N=30 | Control group: general anesthesia (volatile anesthetic) | No difference between groups | (123) |
| N=30 | Studied group: general anesthesia (volatile anesthetic) + PVB (ropivacaine bolus and infusion) | |||
| Breast | N=1065 | Control group: general anesthesia (sevoflurane) | No difference between groups | (124) |
| N=1043 | Studied group: general anesthesia (propofol) + PVB | |||
| Breast | N=58 | Control group: general anesthesia (propofol) | No difference between groups | (125) |
| N=56 | Studied group: general anesthesia + single injection PVB (ropivacaine) | |||
| N=59 | Studied group: general anesthesia + continuous-PVB (ropivacaine for 72h) | |||
| Colon | N=92 | Control group: general anesthesia (isoflurane)+ fentanyl | Epidural improved survival in patients without metastases (p=0.012) | (120) |
| N=85 | Studied group: general anesthesia (isoflurane) + fentanyl + epidural group (bupivacaine) | |||
| Colon Rectum | N=30 | Control group: general anesthesia (propofol+ remifentanyl); postoperative: PCA fentanyl | No difference for postoperative NK cell cytotoxicity and IL-2, recurrence or metastasis | (126) |
| N=30 | Studied group: general anesthesia (propofol and remifentanyl) + surgical wound infiltration of ropivacaine | |||
| Liver | N=20 | Control group: tramadol injections | Ropivacaine increased postoperative survival (p=0.029) | (122) |
| N=20 | Studied group: local incision analgesia (ropivacaine bolus + infiltration) | |||
| N=20 | Studied group: PCA (fentanyl) | |||
| Lung | N=200 | Control group: general anesthesia (propofol/sevoflurane+ sufentanyl/remifentanyl); postoperative: PCA morphine | No difference between groups for recurrence-free and overall survival | (127) |
| N=200 | Studied group: general anesthesia (propofol/sevoflurane+ sufentanyl/remifentanyl)+ epidural anesthesia (ropivacaine) | |||
| Prostate | N=50 | Control group: general anesthesia; postoperative: morphine | No difference between groups | (128) |
| N=49 | Studied group: general anesthesia + ropivacaine bolus and infusion with fentanyl | |||
| Solid tumors | N=216 | Control group: general anesthesia; postoperative: opioid-based analgesia | No difference between groups | (129) |
| N=230 | Studied group: general anesthesia + epidural group (bupivacaine or ropivacaine); postoperative: continous bupivacaine or ropivacaine + fentanyl or pethidine | |||
| Solid tumors | N=822 | Control group: general anesthesia (propofol/sevoflurane+ sufentanyl/remifentanyl/fentanyl); postoperative: PCA morphine | No difference between groups for overall survival | (130) |
| N=772 | Studied group: general anesthesia (propofol/sevoflurane+ sufentanyl/remifentanyl/fentanyl)+ epidural anesthesia (ropivacaine) |
PCA, patient-controlled analgesia; NK, natural killer; PVB, paravertebral block.