Choice of anesthetic for cancer resection

2017 J. Clin Anesth

Three retrospective studies presented a hazard ratio (HR) adjusting for several confounders. One study reported an increased overall mortality after INHA with a HR of 1.47 (95% CI 1.31-1.64, p≤0.001), while another study reported a tendency of decreased overall mortality after TIVA (HR 0.85, 95% CI 0.72-1.00, p=0.051). A third study showed no difference in the overall mortality, but prolonged recurrence-free survival after TIVA with a HR of 0.48 (95% CI 0.27-0.86, p=0.014). In one study, the rate of pulmonary complications was significantly higher after INHA compared with TIVA, while other postoperative complications were comparable. There are currently four propensity-adjusted retrospective studies indicating that TIVA might be the preferred anesthetic choice in cancer surgery. However, evidence is currently of low quality and randomized clinical trials are required for further investigation. https://pubmed.ncbi.nlm.nih.gov/33105278/ https://pubmed.ncbi.nlm.nih.gov/36431218/ https://pubmed.ncbi.nlm.nih.gov/35637441/ https://pubmed.ncbi.nlm.nih.gov/39039548/