L'anesthésie, l'analgésie et la modulation sympathique augmentent-elles l'incidence des récidives néoplasiques après chirurgie? Une revue de la littérature centrée sur la modulation de l'activité des lymphocytes natural killer

Translated title of the contribution: Could anaesthesia, analgesia and sympathetic modulation affect neoplasic recurrence after surgery?: A systematic review centred over the modulation of natural killer cells activity

P. Forget, M. De Kock

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective
The Natural Killer cells (NK) are an important part of non-specific cellular-mediated and antitumoral immunity. The goal of this review is to recapitulate data published over NK activity during the perioperative period and the influence of anaesthesia, analgesia and modulation of sympathetic system.

Data sources
Pubmed/Medline database.

Study selection and data extraction
Keywords-based selection, without limit of date: fundamental studies, randomized controlled trials and non-randomized comparative studies.

Data synthesis
In human as in animal studies, an important correlation exists between NK activity and prognosis linked to the development of metastasis. The great depression of this cytotoxicity during the perioperative period could be able to compromise host defenses. The influence of anaesthetics and analgesics is important. The effects of the opioids, the agonists and the antagonists of the sympathetic nervous system, the prostaglandins, the NSAIDs, the ketamine, the hypnotics and the locoregional anaesthesia are systematically reviewed. The limits of experimental model presented are covered.

Conclusion
The effects of anaesthetic/analgesic drugs and techniques, the consequences of sympathomodulation on NK activity are numerous and sometimes opposite. It is important for the anaesthesiologist to keep in mind that the long term consequences of his techniques on the patients’ outcome must be clarified.
Translated title of the contributionCould anaesthesia, analgesia and sympathetic modulation affect neoplasic recurrence after surgery?: A systematic review centred over the modulation of natural killer cells activity
Original languageFrench
Pages (from-to)751-768
Number of pages18
JournalAnnales Francaises d'Anesthesie et de Reanimation
Volume28
Issue number9
Early online date29 Aug 2009
DOIs
Publication statusPublished - Sep 2009

Keywords

  • anaesthesia
  • analgesia
  • sympathetic system
  • immunity
  • natural killer cells

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