Anesthetic Technique and the Cytokine and Matrix Metalloproteinase Response to Primary Breast Cancer Surgery
Breast cancer is the most common malignancy in women. Surgery remains the most effective treatment. Several perioperative factors, including the surgical stress response, many anesthetics and opioids, adversely affect immune function. Regional anesthesia-analgesia attenuates perioperative immunosupp...
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| Veröffentlicht in: | Regional anesthesia and pain medicine 2010-11, Vol.35 (6), p.490-495 |
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| creator | Deegan, Catherine A. Murray, David Doran, Peter Moriarty, Denis C. Sessler, Daniel I. Mascha, Ed Kavanagh, Brian P. Buggy, Donal J. |
| description | Breast cancer is the most common malignancy in women. Surgery remains the most effective treatment. Several perioperative factors, including the surgical stress response, many anesthetics and opioids, adversely affect immune function. Regional anesthesia-analgesia attenuates perioperative immunosuppression. We tested the hypothesis that patients who receive combined propofol/paravertebral anesthesia-analgesia (propofol/paravertebral) exhibited reduced levels of protumorigenic cytokines and matrix metalloproteinases (MMPs) and elevated levels of antitumorigenic cytokines compared with patients receiving sevoflurane anesthesia with opioid analgesia (sevoflurane/opioid).
Primary breast cancer surgery patients were randomized to propofol/paravertebral (n = 15) or sevoflurane/opioid (n = 17) and preoperative and postoperative serum concentrations of 11 cytokines (interleukin 1β [IL-1β], IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon γ, and tumor necrosis factor α) and 3 MMPs (MMP-1, MMP-3, and MMP-9) were measured.
Treatment groups were well balanced for age, weight, surgical procedure, and cancer pathologic diagnosis. Pain scores were lower at 1 and 2 hrs with paravertebral analgesia compared with morphine but similar at 24 hrs. Patients in the propofol/paravertebral group showed a greater percentage decrease in postoperative compared with preoperative IL-1β (median [quartiles], −26% [−15% to −52%] versus −4% [−14% to 2%],
P = 0.003), a significant attenuation in elevated MMP-3 (2% [−39% to 12%] versus 29% [23%–59%],
P = 0.011) and MMP-9 (26% [13%–54%] versus 74% [50%–108%],
P = 0.02), and a significant increase in IL-10 (10% [5%–33%] versus −15% [20% to −2%],
P = 0.001) compared with sevoflurane/opioid group. No significantly different changes in IL-2, IL-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, interferon γ, tumor necrosis factor α, or MMP-1 were observed between the 2 groups.
Propofol/paravertebral anesthesia-analgesia for breast cancer surgery alters a minority of cytokines influential in regulating perioperative cancer immunity. Further evaluation is required to determine the significance of these observations. |
| doi_str_mv | 10.1097/AAP.0b013e3181ef4d05 |
| format | Article |
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Primary breast cancer surgery patients were randomized to propofol/paravertebral (n = 15) or sevoflurane/opioid (n = 17) and preoperative and postoperative serum concentrations of 11 cytokines (interleukin 1β [IL-1β], IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon γ, and tumor necrosis factor α) and 3 MMPs (MMP-1, MMP-3, and MMP-9) were measured.
Treatment groups were well balanced for age, weight, surgical procedure, and cancer pathologic diagnosis. Pain scores were lower at 1 and 2 hrs with paravertebral analgesia compared with morphine but similar at 24 hrs. Patients in the propofol/paravertebral group showed a greater percentage decrease in postoperative compared with preoperative IL-1β (median [quartiles], −26% [−15% to −52%] versus −4% [−14% to 2%],
P = 0.003), a significant attenuation in elevated MMP-3 (2% [−39% to 12%] versus 29% [23%–59%],
P = 0.011) and MMP-9 (26% [13%–54%] versus 74% [50%–108%],
P = 0.02), and a significant increase in IL-10 (10% [5%–33%] versus −15% [20% to −2%],
P = 0.001) compared with sevoflurane/opioid group. No significantly different changes in IL-2, IL-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, interferon γ, tumor necrosis factor α, or MMP-1 were observed between the 2 groups.
Propofol/paravertebral anesthesia-analgesia for breast cancer surgery alters a minority of cytokines influential in regulating perioperative cancer immunity. Further evaluation is required to determine the significance of these observations.</description><identifier>ISSN: 1098-7339</identifier><identifier>EISSN: 1532-8651</identifier><identifier>DOI: 10.1097/AAP.0b013e3181ef4d05</identifier><identifier>PMID: 20975461</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject><![CDATA[Aged ; Analgesics, Opioid - administration & dosage ; Anesthesia ; Anesthesia, Conduction ; Anesthetics, Inhalation - administration & dosage ; Anesthetics, Intravenous - administration & dosage ; Anesthetics, Local - administration & dosage ; Breast cancer ; Breast Neoplasms - enzymology ; Breast Neoplasms - immunology ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Bupivacaine - administration & dosage ; Bupivacaine - analogs & derivatives ; Cancer surgery ; Cytokines ; Cytokines - blood ; Female ; Humans ; Immunity, Cellular - drug effects ; Interferon-gamma - blood ; Interleukins - blood ; Ireland ; Levobupivacaine ; Mastectomy ; Matrix Metalloproteinase 1 - blood ; Matrix Metalloproteinase 3 - blood ; Matrix Metalloproteinase 9 - blood ; Matrix Metalloproteinases - blood ; Methyl Ethers - administration & dosage ; Middle Aged ; Morphine - administration & dosage ; Narcotics ; Nerve Block ; Pain, Postoperative - etiology ; Pain, Postoperative - prevention & control ; Pilot Projects ; Propofol - administration & dosage ; Regional anesthesia ; Sevoflurane ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha - blood ; Tumor necrosis factor-TNF]]></subject><ispartof>Regional anesthesia and pain medicine, 2010-11, Vol.35 (6), p.490-495</ispartof><rights>2010 American Society of Regional Anesthesia</rights><rights>Copyright © 2010 by American Society of Regional Anesthesia and Pain Medicine2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-e5cc70bafd9e60a8586421df24fd0767b17aacaaa02db8ebf2997a145b64346f3</citedby><cites>FETCH-LOGICAL-c455t-e5cc70bafd9e60a8586421df24fd0767b17aacaaa02db8ebf2997a145b64346f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20975461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Deegan, Catherine A.</creatorcontrib><creatorcontrib>Murray, David</creatorcontrib><creatorcontrib>Doran, Peter</creatorcontrib><creatorcontrib>Moriarty, Denis C.</creatorcontrib><creatorcontrib>Sessler, Daniel I.</creatorcontrib><creatorcontrib>Mascha, Ed</creatorcontrib><creatorcontrib>Kavanagh, Brian P.</creatorcontrib><creatorcontrib>Buggy, Donal J.</creatorcontrib><title>Anesthetic Technique and the Cytokine and Matrix Metalloproteinase Response to Primary Breast Cancer Surgery</title><title>Regional anesthesia and pain medicine</title><addtitle>Reg Anesth Pain Med</addtitle><description>Breast cancer is the most common malignancy in women. Surgery remains the most effective treatment. Several perioperative factors, including the surgical stress response, many anesthetics and opioids, adversely affect immune function. Regional anesthesia-analgesia attenuates perioperative immunosuppression. We tested the hypothesis that patients who receive combined propofol/paravertebral anesthesia-analgesia (propofol/paravertebral) exhibited reduced levels of protumorigenic cytokines and matrix metalloproteinases (MMPs) and elevated levels of antitumorigenic cytokines compared with patients receiving sevoflurane anesthesia with opioid analgesia (sevoflurane/opioid).
Primary breast cancer surgery patients were randomized to propofol/paravertebral (n = 15) or sevoflurane/opioid (n = 17) and preoperative and postoperative serum concentrations of 11 cytokines (interleukin 1β [IL-1β], IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon γ, and tumor necrosis factor α) and 3 MMPs (MMP-1, MMP-3, and MMP-9) were measured.
Treatment groups were well balanced for age, weight, surgical procedure, and cancer pathologic diagnosis. Pain scores were lower at 1 and 2 hrs with paravertebral analgesia compared with morphine but similar at 24 hrs. Patients in the propofol/paravertebral group showed a greater percentage decrease in postoperative compared with preoperative IL-1β (median [quartiles], −26% [−15% to −52%] versus −4% [−14% to 2%],
P = 0.003), a significant attenuation in elevated MMP-3 (2% [−39% to 12%] versus 29% [23%–59%],
P = 0.011) and MMP-9 (26% [13%–54%] versus 74% [50%–108%],
P = 0.02), and a significant increase in IL-10 (10% [5%–33%] versus −15% [20% to −2%],
P = 0.001) compared with sevoflurane/opioid group. No significantly different changes in IL-2, IL-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, interferon γ, tumor necrosis factor α, or MMP-1 were observed between the 2 groups.
Propofol/paravertebral anesthesia-analgesia for breast cancer surgery alters a minority of cytokines influential in regulating perioperative cancer immunity. Further evaluation is required to determine the significance of these observations.</description><subject>Aged</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Anesthesia</subject><subject>Anesthesia, Conduction</subject><subject>Anesthetics, Inhalation - administration & dosage</subject><subject>Anesthetics, Intravenous - administration & dosage</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - enzymology</subject><subject>Breast Neoplasms - immunology</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Bupivacaine - administration & dosage</subject><subject>Bupivacaine - analogs & derivatives</subject><subject>Cancer surgery</subject><subject>Cytokines</subject><subject>Cytokines - blood</subject><subject>Female</subject><subject>Humans</subject><subject>Immunity, Cellular - drug effects</subject><subject>Interferon-gamma - 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administration & dosage</topic><topic>Anesthesia</topic><topic>Anesthesia, Conduction</topic><topic>Anesthetics, Inhalation - administration & dosage</topic><topic>Anesthetics, Intravenous - administration & dosage</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - enzymology</topic><topic>Breast Neoplasms - immunology</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Bupivacaine - administration & dosage</topic><topic>Bupivacaine - analogs & derivatives</topic><topic>Cancer surgery</topic><topic>Cytokines</topic><topic>Cytokines - blood</topic><topic>Female</topic><topic>Humans</topic><topic>Immunity, Cellular - drug effects</topic><topic>Interferon-gamma - blood</topic><topic>Interleukins - blood</topic><topic>Ireland</topic><topic>Levobupivacaine</topic><topic>Mastectomy</topic><topic>Matrix Metalloproteinase 1 - blood</topic><topic>Matrix Metalloproteinase 3 - blood</topic><topic>Matrix Metalloproteinase 9 - blood</topic><topic>Matrix Metalloproteinases - blood</topic><topic>Methyl Ethers - administration & dosage</topic><topic>Middle Aged</topic><topic>Morphine - administration & dosage</topic><topic>Narcotics</topic><topic>Nerve Block</topic><topic>Pain, Postoperative - etiology</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Pilot Projects</topic><topic>Propofol - administration & dosage</topic><topic>Regional anesthesia</topic><topic>Sevoflurane</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Tumor Necrosis Factor-alpha - blood</topic><topic>Tumor necrosis factor-TNF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Deegan, Catherine A.</creatorcontrib><creatorcontrib>Murray, David</creatorcontrib><creatorcontrib>Doran, Peter</creatorcontrib><creatorcontrib>Moriarty, Denis C.</creatorcontrib><creatorcontrib>Sessler, Daniel I.</creatorcontrib><creatorcontrib>Mascha, Ed</creatorcontrib><creatorcontrib>Kavanagh, Brian P.</creatorcontrib><creatorcontrib>Buggy, Donal J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Regional anesthesia and pain medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Deegan, Catherine A.</au><au>Murray, David</au><au>Doran, Peter</au><au>Moriarty, Denis C.</au><au>Sessler, Daniel I.</au><au>Mascha, Ed</au><au>Kavanagh, Brian P.</au><au>Buggy, Donal J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anesthetic Technique and the Cytokine and Matrix Metalloproteinase Response to Primary Breast Cancer Surgery</atitle><jtitle>Regional anesthesia and pain medicine</jtitle><addtitle>Reg Anesth Pain Med</addtitle><date>2010-11-01</date><risdate>2010</risdate><volume>35</volume><issue>6</issue><spage>490</spage><epage>495</epage><pages>490-495</pages><issn>1098-7339</issn><eissn>1532-8651</eissn><abstract>Breast cancer is the most common malignancy in women. Surgery remains the most effective treatment. Several perioperative factors, including the surgical stress response, many anesthetics and opioids, adversely affect immune function. Regional anesthesia-analgesia attenuates perioperative immunosuppression. We tested the hypothesis that patients who receive combined propofol/paravertebral anesthesia-analgesia (propofol/paravertebral) exhibited reduced levels of protumorigenic cytokines and matrix metalloproteinases (MMPs) and elevated levels of antitumorigenic cytokines compared with patients receiving sevoflurane anesthesia with opioid analgesia (sevoflurane/opioid).
Primary breast cancer surgery patients were randomized to propofol/paravertebral (n = 15) or sevoflurane/opioid (n = 17) and preoperative and postoperative serum concentrations of 11 cytokines (interleukin 1β [IL-1β], IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon γ, and tumor necrosis factor α) and 3 MMPs (MMP-1, MMP-3, and MMP-9) were measured.
Treatment groups were well balanced for age, weight, surgical procedure, and cancer pathologic diagnosis. Pain scores were lower at 1 and 2 hrs with paravertebral analgesia compared with morphine but similar at 24 hrs. Patients in the propofol/paravertebral group showed a greater percentage decrease in postoperative compared with preoperative IL-1β (median [quartiles], −26% [−15% to −52%] versus −4% [−14% to 2%],
P = 0.003), a significant attenuation in elevated MMP-3 (2% [−39% to 12%] versus 29% [23%–59%],
P = 0.011) and MMP-9 (26% [13%–54%] versus 74% [50%–108%],
P = 0.02), and a significant increase in IL-10 (10% [5%–33%] versus −15% [20% to −2%],
P = 0.001) compared with sevoflurane/opioid group. No significantly different changes in IL-2, IL-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, interferon γ, tumor necrosis factor α, or MMP-1 were observed between the 2 groups.
Propofol/paravertebral anesthesia-analgesia for breast cancer surgery alters a minority of cytokines influential in regulating perioperative cancer immunity. Further evaluation is required to determine the significance of these observations.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>20975461</pmid><doi>10.1097/AAP.0b013e3181ef4d05</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1098-7339 |
| ispartof | Regional anesthesia and pain medicine, 2010-11, Vol.35 (6), p.490-495 |
| issn | 1098-7339 1532-8651 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_760238302 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Aged Analgesics, Opioid - administration & dosage Anesthesia Anesthesia, Conduction Anesthetics, Inhalation - administration & dosage Anesthetics, Intravenous - administration & dosage Anesthetics, Local - administration & dosage Breast cancer Breast Neoplasms - enzymology Breast Neoplasms - immunology Breast Neoplasms - pathology Breast Neoplasms - surgery Bupivacaine - administration & dosage Bupivacaine - analogs & derivatives Cancer surgery Cytokines Cytokines - blood Female Humans Immunity, Cellular - drug effects Interferon-gamma - blood Interleukins - blood Ireland Levobupivacaine Mastectomy Matrix Metalloproteinase 1 - blood Matrix Metalloproteinase 3 - blood Matrix Metalloproteinase 9 - blood Matrix Metalloproteinases - blood Methyl Ethers - administration & dosage Middle Aged Morphine - administration & dosage Narcotics Nerve Block Pain, Postoperative - etiology Pain, Postoperative - prevention & control Pilot Projects Propofol - administration & dosage Regional anesthesia Sevoflurane Time Factors Treatment Outcome Tumor Necrosis Factor-alpha - blood Tumor necrosis factor-TNF |
| title | Anesthetic Technique and the Cytokine and Matrix Metalloproteinase Response to Primary Breast Cancer Surgery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T20%3A05%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Anesthetic%20Technique%20and%20the%20Cytokine%20and%20Matrix%20Metalloproteinase%20Response%20to%20Primary%20Breast%20Cancer%20Surgery&rft.jtitle=Regional%20anesthesia%20and%20pain%20medicine&rft.au=Deegan,%20Catherine%20A.&rft.date=2010-11-01&rft.volume=35&rft.issue=6&rft.spage=490&rft.epage=495&rft.pages=490-495&rft.issn=1098-7339&rft.eissn=1532-8651&rft_id=info:doi/10.1097/AAP.0b013e3181ef4d05&rft_dat=%3Cproquest_cross%3E760238302%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2553091654&rft_id=info:pmid/20975461&rft_els_id=S1098733910603355&rfr_iscdi=true |