Date of this Version

2023

Document Type

DNP Project

Abstract

Abstract

Background: Current data indicates that anesthetic agents can modulate the immune system and response. The extent of anesthesia's contribution to immunosuppression and the proliferation and migration of circulating tumor cells, resulting in an increased risk of cancer metastasis, recurrence, and morbidity, is unclear. Emerging evidence suggests Sevoflurane may accelerate tumor growth and recurrence in oncology patients. Conversely, recent studies demonstrate Propofol's ability to preserve or enhance immune function. 39.5% of men and women will be diagnosed with cancer at some point in their lifetime, and over 60% of cancer patients will undergo surgery as a form of treatment. However, there are currently no standard recommendations for the anesthesia management of these patients. The three most common cancers worldwide responsible for the most deaths are breast, lung, and colorectal. Therefore, comparative studies of anesthesia modalities in these deadly cancers were analyzed to generate perioperative anesthetic management guidelines most beneficial for the surgical oncology population.

Aim: This study aims to educate anesthesia providers on the harmful effects of anesthesia modalities on cancer patients and provide evidence-based recommendations to improve clinical decision-making and patient outcomes.

Methods: The educational intervention will be conveyed by a 10-minute virtual PowerPoint presentation, with a pretest and posttest questionnaire delivered by a URL link electronically via Qualtrics, an online survey product. Responses to pretest and posttest surveys are not linked to any participant. The collected information is reported as an aggregate, and there is no monetary compensation for participation. Once results are collected, and data synthesized, a statistical analysis of findings will reveal correlations.

Results: The findings generated positive outcomes, anesthesia provider knowledge on the harmful effects of anesthesia modalities on cancer patients was enhanced, inclination to utilize Propofol TIVA on patients with deadly cancers was increased, and overall enriched clinical decision-making. Ultimately, the Quality Improvement was able to answer to the research question.

Discussion: Further research is indicated. However, the performed QI is promising. A paradigm shift in the anesthetic management of surgical oncology patients could signify an overall reduction in cancer recurrence rates, tumor metastasis, and mortality rates, particularly in deadly cancers. Increased participant knowledge of the harmful effects of anesthesia modalities and evidence-based recommendations for these cancer patients will improve clinical decision-making and patient outcomes.

Keywords: Cancer, recurrence, immunosuppression, tumor, tumorigenic, Anesthesia modality, techniques, Propofol-based, Sevoflurane-based, immunomodulation, Flow Cytometry

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