Regional anaesthesia in cancer surgery: an update

Anaesthetic techniques can influence the cellular immune system and affect long term outcome. Cancer surgery itself and general anaesthetics, especially opioids, suppress immunity and therefore promote metastases. Regional anaesthesia attenuates the immunosuppressive effect of surgery. Local anaesthetics, contrary to opioids, stimulate the activity of natural killer (NK) cells during the perioperative period. All techniques of regional anaesthesia are very useful and applicable in cancer surgery, either for the anaesthesia itself or for the treatment of postoperative pain. The relationship between regional anaesthesia and cancer recurrence is one of the most interesting topics in anaesthesia today, but we must wait the results of prospective trials before definitive conclusions.