Effect of Anaesthesia Technique on anti-tumor Immunity through TGF-β levels in Adult Patients Undergoing Surgery for Oral Cancer

Mathur, Tanmay; Bharti, Sachidanand Jee; Kumari, Lata; Kaushik, Shivani; Ratre, Brajesh Kumar; Bhatnagar, Sushma; Mishra, Seema; Gupta, Nishkarsh; Garg, Rakesh; Kumar, Vinod; Khan, Maroof Ahmad; Kumar, Sunil; Deepak, Rakesh Kumar

doi:10.31557/APJCP.2024.25.12.4257

Effect of Anaesthesia Technique on anti-tumor Immunity through TGF-β levels in Adult Patients Undergoing Surgery for Oral Cancer

Document Type : Research Articles

Authors

All India Institute of Medical Sciences, New Delhi, India.

10.31557/APJCP.2024.25.12.4257

Abstract

Background: There is a paucity of literature regarding the effect of anesthetic techniques on anti-tumor immunity, especially in Oral cavity Malignancies. We designed a study to evaluate the effect of 3 anesthetic techniques – Opioid, Lignocaine infusion and Dexmeditomedine infusion-based on anti-tumor immunity, using TGF-β, T-helper cell profile and inflammatory markers such as IL-6 and IL-10. Methods: A pilot prospective randomized trial was conducted in 90 patients undergoing surgery for Oral cavity malignancy under general anesthesia in a tertiary specialty cancer hospital. Adult cancer patients of the American Society of Anaesthesiologists (ASA) physical status I-III fulfilling the inclusion criteria were randomized to either group A (Opioid general anesthesia), group B (lignocaine infusion-based general anesthesia), or group C (Dexmedetomidine infusion-based general anesthesia). Preoperative (morning of surgery) and postoperative (24 hours after surgery) blood samples were obtained. Statistical analysis was done, and the results were analyzed. Results: Demographic profile and pre-operative parameters were comparable between both groups. We did not find any statistically significant difference in the Post-operative levels of TGF-β, neutrophil-lymphocyte ratio (NLR), Monocyte Lymphocyte Ratio (MLR), platelet lymphocyte ratio (PLR), IL-6, IL-10, and T-helper cell profile( IFN-γ, IL-17A, and IL-4 as surrogate markers) among the three study groups. However, it was noted that the overall Opioid consumption was markedly reduced in Group C without any major adverse effects being noted.

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