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Anaesthesia & cancer
Effect of neoadjuvant chemotherapy on intraoperative core temperature in patients with breast cancer: a retrospective cohort study
Clinical evidence suggests that chemotherapeutic agents are associated with neuropathy and peripheral autonomic dysfunction. However, the possible effects of neoadjuvant chemotherapy on intraoperative temperature remain poorly characterised.Nociceptin/Orphanin FQ receptor expression in primary human umbilical vein endothelial cells is not regulated by exposure to breast cancer cell media or angiogenic stimuli
Opioid receptors are naloxone-sensitive (MOP [mu: μ], DOP [delta: δ], and KOP [kappa: κ]) and naloxone-insensitive Nociceptin/Orphanin FQ (N/OFQ) peptide receptor (NOP). Clinically, most opioid analgesics target MOP. Angiogenesis is the formation of new blood vessels and involves endothelial cell activation, proliferation, and migration. The effect of opioids on this process is controversial with no data for NOP receptor ligands.Successful epidural fibrin glue patch to treat intracranial hypotension in a patient with bacteraemia and malignancy
Cerebrospinal fluid leaks after diagnostic lumbar puncture are often treated using an epidural blood patch; however, there are situations in which this may not be a desirable or safe option. We describe a case of a 55-yr-old male who developed a cerebrospinal fluid leak with intracranial hypotension and subdural haematoma after multiple diagnostic lumbar punctures who also had Klebsiella bacteraemia, malignancy, and low platelets. Given concern about bacterial and malignant seeding of the epidural space, we considered several options including a patch with banked blood or neurosurgical intervention.Perioperative blood transfusion in major abdominal cancer surgery: a multi-centre service evaluation and national survey
Anaemia is associated with complications and death after surgery. Perioperative red-cell transfusion triggers are not well defined in patients having oncological surgery, or with cardiovascular disease.Opioids and cancer survival: are we looking in the wrong place?
There is a controversial narrative in the anaesthetic literature suggesting that anaesthetic technique (including opioids) may be detrimental to survival after tumour resection. The initial observations were retrospective. Several prospective studies are ongoing; one in breast cancer has reported no adverse outcome. The evidence for an effect of opioids stems from three pieces of information: (1) opioids depress the immune system, (2) opioids potentially promote angiogenesis, and (3) opioids potentially support tumour growth.
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