Regional anaesthesia and cancer metastases: the implication of local anaesthetics

Clinical and basic science studies have demonstrated the anti‐inflammatory properties of local anaesthetics. Recent studies have begun to unravel molecular pathways linking inflammation and cancer. Regional anaesthesia is associated in some retrospective clinical studies with reduced risk of metasta...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2013-11, Vol.57 (10), p.1211-1229
Main Authors: VOTTA-VELIS, E. G., PIEGELER, T., MINSHALL, R. D., AGUIRRE, J., BECK-SCHIMMER, B., SCHWARTZ, D. E., BORGEAT, A.
Format: Article
Language:English
Subjects:
Acute Lung Injury - drug therapy
Anesthesia, Conduction
Anesthetics, Local - pharmacology
Animals
Anti-Inflammatory Agents - pharmacology
Cancer
Humans
Inflammation - complications
Medical research
Medical treatment
Neoplasm Metastasis - prevention & control
Neoplastic Cells, Circulating
NF-kappa B - physiology
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Summary:Clinical and basic science studies have demonstrated the anti‐inflammatory properties of local anaesthetics. Recent studies have begun to unravel molecular pathways linking inflammation and cancer. Regional anaesthesia is associated in some retrospective clinical studies with reduced risk of metastasis and increased long‐term survival. The potential beneficial effects of regional anaesthesia have been attributed mainly to the inhibition of the neuroendocrine stress response to surgery and to the reduction in the requirements of volatile anaesthetics and opioids. Because cancer is linked to inflammation and local anaesthetics have anti‐inflammatory effects, these agents may participate in reducing the risk of metastasis, but their mechanism of action is unknown. We demonstrated in vitro that amide local anaesthetics attenuate tumour cell migration as well as signalling pathways enhancing tumour growth and metastasis. This has provided the first evidence of a molecular mechanism by which regional anaesthesia might inhibit or reduce cancer metastases.
ISSN:0001-5172
1399-6576
DOI:10.1111/aas.12210