Page 49 - CASA Bulletin of Anesthesiology 2019 Vol 6 No 5

Vol.6, No.5, 2019

DOI: 10.31480/2330-4871/099
of morphine on tumor progression: Use of the regional tion of chronic opioid intake warrants precision driven
anesthesia, co-application of peripherally restricted opi- human studies. The promising direction of the anesthe-
oids antagonists, and/or change in narcotics given. Any siology-relevant discovery lies in understanding cancer
of these approaches need to be clinically verified. progression, metabolic effects, and the ability to handle
The effect of prolonged opioids intake on seizure the acute stress in a patient taking opioids chronically.
threshold, glucose metabolism or stress response has Declarations
been demonstrated, but lack of clinical translation pre-
cludes providing a specific recommendation for anes- Ethics approval and consent to participate - Not
thesia plan preparation in addition to ASA standards. applicable.
Finally, it is important to remain cognizant of the dif- Competing Interests
ferential efficacy of opioid therapy according to sex. Al- The authors declare that they have no competing
though the mechanism of this difference has still yet to interests.
be elucidated, multiple clinical studies have shown that
women frequently experience more pain during surgical Funding
procedures and often require more opioids to achieve This research did not receive any specific grant from
similar analgesia to men [48,78-80]. Understanding the funding agencies in the public, commercial, or not-for-
magnitude of this effect should guide perioperative spe- profit sectors.
cialists to manage patients accordingly in the postoper-
ative period. Authors’ Statement
Future Research Directions All authors reviewed the final version of manuscript
and agreed for its publication.
Lack of well controlled, prospective studies conduct-
ed with patients is the most important recommenda- Acknowledgment
tion for research progress in the future. Small studies This work was supported by NIH NIGM K23
with well-controlled confounders, with sound method- GM120630 awarded to KL
ology (longitudinal series), can provide a high level of
evidence leading to formulating a recommendation for References
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the progression of the cancer is a potentially promis- [cited 6 Mar 2018]. Available: https://www.drugabuse.gov/
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Despite several years of research, we still possess a opioid therapy in long-term cancer survivors. Clin Transl Oncol
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