Regional anaesthesia and cancer metastases: the implication of local anaesthetics
E. G. VOTTA-VELIS et al.
Acta Anaesthesiologica Scandinavica
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.
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