Impact of opioid-free general anesthesia with locoregional blocks during breast cancer surgery on systemic inflammatory response: results from a randomized controlled trial

For breast cancer patients with localized disease, surgery remains a cornerstone of treatment. Anesthesia during surgery is essential for pain management and influences patient recovery. Opioid-free general anesthesia with locoregional blocks (OfGA), as an alternative to traditional opioid-based general anesthesia (GA), may improve patient outcomes.

We set up a randomized trial to compare the impact of different anesthetic approaches on post surgical inflammation in breast cancer patients undergoing quadrantectomy. Patients were randomized to receive GA (n=34) or OfGA (n=34). Blood samples were collected pre-surgery and 1 hour and 24 hours post-surgery. As primary endpoint, neutrophil-to-lymphocyte ratio (NLR) was calculated. As secondary endpoints we collected data on side effects, pain management, and circulating inflammatory cytokines.