Anesthesia and Postoperative Outcome in Colorectal Cancer Patients

The Influence of Anesthesia on Postoperative Outcome and Complications in Colorectal Cancer Patients

Study aims to compare the influence of TIVA and sevoflurane anesthesia with or without lidocaine on postoperative short and long term outcome in patients with colorectal cancer undergoing surgery.

As short term endpoints postoperative pain and opioid consumption, resumption of bowel function, PONV, LOS will be registered.

Long term outcome parameters include: the incidence of chronic pain, 1 and 5 years cancer recurrences incidence and mortality.

Main goals

1. Comparative evaluation of the incidence of recurrences after TIVA vs sevoflurane anesthesia
2. Evaluation of the effect of lidocaine infusion associated with TIVA/sevoflurane on the incidence of chronic pain and of cancer recurrences and survival.

Secondary objectives

1. Evaluation of the influence of lidocaine on postoperative outcome in patients with colorectal cancer
2. Evaluation of the influence of lidocaine on postoperative inflammatory response
3. Evaluation of the influence of lidocaine on the incidence and severity of postoperative pain and outcome in patients with colorectal cancer

Inclusion Criteria:

• Elective surgery

Exclusion Criteria:

• • persistent chronic pain

  • chronic medication that may interfere with pain: antiepileptics, NSAID, corticoids
  • Contraindications for any of the study medications
  • Significant psychiatric disorders (Axa I) (major depression, bipolar disorders, schizophrenia, etc.)
  • Significant hepatic (ALAT and/or ASAT > 2 normal values) or renal (plasma creatinine > 2 mg/dl) disorders
  • Convulsive disorders requiring medication during the last 2 years
  • Planned regional analgesia/anesthesia (spinal or epidural)
  • Corticoid dependent asthma
  • Autoimmune disorders
  • Anti-arrhythmic medication (verapamil, propafenone, amiodarone) that may interfere with lidocaine's anti-arrhythmic effects
  • Refusal for study participation