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      Current Understanding on Perioperative Management in Lung Cancer: Implications for Anesthetic Considerations

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          Abstract

          Narcotic drugs are often used to treat perioperative pain for patients with lung cancer. However, anesthetic management and narcotic substance use may have significant impacts on patients with lung cancer, including anti-cancer or promoting cancer effects. In this study, we summarize the effects of anesthetic management and its related substances on lung cancer. An evidence-based review of the influence of anesthetic techniques and narcotic substances used on lung cancer was performed. The effects of perioperative pain management and the method of choosing anesthesia for patients with lung cancer were explored. Different management techniques of anesthesia have been indicated to suppress both cell-mediated immunity and humoral immunity and have effects on the recurrence and metastasis of lung cancer. Evidence suggests that the effects of narcotic substances used on lung cancer were still inconsistent. However, the mechanisms by which anesthetics and analgesics inhibit the tumor are complicated. Perioperative management leads to decreased immunity in patients with lung cancer, which to some extent contributes to recurrence and metastasis. Various narcotic substances used may modulate signal pathways, including the mitochondrial pathway, and appear to exert different effects on the recurrence and metastasis of lung cancer. The anesthesiologists should consider these effects on perioperative management with lung cancer.

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          Most cited references 42

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                Author and article information

                Journal
                Drug Des Devel Ther
                Drug Des Devel Ther
                dddt
                dddt
                Drug Design, Development and Therapy
                Dove
                1177-8881
                25 February 2021
                2021
                : 15
                : 835-842
                Affiliations
                [1 ]Department of Anesthesiology, First Hospital of China Medical University , Shenyang, Liaoning, 110001, People’s Republic of China
                [2 ]Department of Ophthalmology, First Hospital of China Medical University , Shenyang, Liaoning, 110001, People’s Republic of China
                [3 ]Department of Gynaecology, The First Affiliated Hospital of China Medical University , Shenyang, Liaoning, 110001, People’s Republic of China
                [4 ]Department of Anesthesiology, Central Hospital, Shenyang Medical College , Shenyang, 110024, People’s Republic of China
                Author notes
                Correspondence: Jinghua Jiao Department of Anesthesiology, Central Hospital, Shenyang Medical College , Shenyang, 110024, People’s Republic of China Email jean0905@163.com
                Yifan Zhong Department of Ophthalmology, First Hospital of China Medical University , Shenyang, Liaoning, 110001, People’s Republic of China Email zhongyifan851111@163.com
                Article
                297200
                10.2147/DDDT.S297200
                7920500
                33658765
                © 2021 Wang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 1, References: 42, Pages: 8
                Funding
                Funded by: the National Natural Science Foundation of China;
                Funded by: Natural Science Foundation of Liaoning Province, open-funder-registry 10.13039/501100005047;
                Funded by: Science and Technology Projects of Shenyang;
                Funded by: Shenyang Young and Middle-aged Science and Technology Innovation Talents;
                This work was supported by the National Natural Science Foundation of China (No. 82003882), Natural Science Foundation of Liaoning Province (No. 2019-ZD-0339), Science and Technology Projects of Shenyang (No. 19-112-4-096), and Shenyang Young and Middle-aged Science and Technology Innovation Talents (No. RC200528).
                Categories
                Review

                Pharmacology & Pharmaceutical medicine

                lung cancer, narcotic substance use, anesthetics

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