Ventajas y desventajas de la técnica de anestesia balanceada Vs. la anestesia total intravenosa -TIVA- en el pronóstico de la cirugía de cáncer frente a la recaída

Abstract

During this review, the specifications of why the TIVA technique is the best option
in patients with diseases metastasized by cancer and even in incipient stages will
be shown since although surgical treatment is nowadays capable of completely
removing the primary tumor and achieving a complete macroscopic debulking, 90%
of cancer-related deaths are due to metastases and not the primary tumor. In this
way, oncological surgery manages to reduce its dissemination and even induces
a postoperative state of immunosuppression, which has become a great challenge
for the anesthesiologist, since this state allows micromestatasis and relapse of the
cancer patient.
Currently an important advance is included, and it is the total intravenous anesthesia,
which involves the induction and maintenance of anesthesia only with intravenous
drugs associated with supplemental oxygen, causing the different components
of the anesthetic state to be controlled separately: hypnosis can be caused with
multiple agents (Barbituric, benzodiazepines, etomidate, or propofol), highlighting
propofol for its pharmacokinetic properties. Analgesia oversees the potent opioids
of the phenylpyperidine group, being the prototype remifentanyl for its attractive
pharmacological profile (18).