title: Best practice in the administration of analgesia in postoncological surgery.
abstract: The rationale for using multimodal analgesia after any major surgery is achievement of adequate analgesia while avoiding the unwanted effects of large doses of any analgesic, in particular opioids. There are two reasons why we can hypothesize that multimodal analgesia might have a significant impact on cancer-related outcomes in the context of oncological orthopedic surgery. First, because multimodal analgesia is a key component of enhanced-recovery pathways and can accelerate return to intended oncological therapy. And second, because some of the analgesic used in multimodal analgesia (i.e., COX inhibitors, local analgesics and dexamethasone) can induce apoptosis in cancer cells and/or diminish the inflammatory response during surgery which itself can facilitate tumor growth.
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas-MD Anderson Cancer Center, Houston, TX 77030, USA.|Anesthesia & Surgical Oncology Research Group.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas-MD Anderson Cancer Center, Houston, TX 77030, USA.|Anesthesia & Surgical Oncology Research Group.
authors.forename: Javier
authors.initials: J
authors.lastname: Lasala
authors.affiliation: University of Parma, Parma, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Bugada
mesh_terms: D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D004359:Drug Therapy, Combination; D006801:Humans; D009369:Neoplasms / Q000601:surgery*; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: cancer; enhanced recovery; multimodal analgesia; surgery; survival