Relationship between perioperative immuno-suppression and postoperative pain

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K08819
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Shinshu University (2019-2020); Kagoshima University (2018)
• Principal Investigator: HASEGAWA MAIKO 信州大学, 学術研究院医学系(医学部附属病院), 准教授 (20516637)
• Co-Investigator(Kenkyū-buntansha): 松永 明 鹿児島大学, 医歯学域鹿児島大学病院, 准教授 (70284883)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 麻酔 / 免疫抑制 / 術後鎮痛

Outline of Final Research Achievements

Study 1: We investigated whether a correlation exists between perioperative immunological changes and the onset of SSI in patients with spinal surgery. Immunological parameters immediately after the end of anesthesia were not different between patients with and without SSI. The postoperative duration of fentanyl infusion was significantly longer in patients with than without SSI
Study 2: Opioids have been implicated in the promotion of cancer recurrence and metastasis because of their immunosuppressive effects. We identified perioperative factors related to postoperative complications and 2-year survival in patients undergoing esophageal cancer surgery. The intraoperative dosage of opioids calculated as fentanyl equivalents was not correlated with any postoperative complications or 2-year survival.

Free Research Field

麻酔科学

Academic Significance and Societal Importance of the Research Achievements

海外ではオピオイド使用量の増加と乱用、免疫抑制による感染症発症への影響が示唆されている。周術期は手術侵襲による免疫抑制とオピオイドの作用が重なり、がん手術では手術操作による腫瘍の散布や播種の可能性がある。またインプラントを挿入する整形外科手術等では、手術部位感染への影響が懸念される。オピオイドだけでなく、吸入麻酔薬も免疫抑制作用を有することが報告されているが、麻酔がこの免疫抑制作用を介して術後合併症、長期予後に及ぼす影響は不明であった。術中オピオイド使用量を含む術中因子と術後予後には、明らかな因果関係はみられなかった。