Anaesthetic and pain management technique in long term cancer outcome – benefits of regional anaesthesia and analgesia in the context of cancer surgery

There has been an assumption, that the pharmacological effects of local anaesthetic agents and/or the analgesic benefits of regional anaesthesia and ­analgesia might lead to a reduction of cancer recurrence and/or metastases after cancer surgery. These benefits over general anaesthesia and opioid-based ­postoperative analgesia were claimed in particular with use of epidural techniques by retrospective studies. However, other retrospective and a number of ­prospective studies have not confirmed this impression in favour of epidural techniques. Similarly, there are inconclusive results with regard to the use of peripheral nerve blocks including paravertebral blocks and the use of spinal anaesthesia. Despite the theoretical potential of local anaesthetics and regional techniques, supported by in-vitro and animal studies, the current clinical situation is equivocal and ­further well-designed prospective studies are required to address this issue definitively.