Perioperative analgesia and immune suppression

Abstract

Opioid misuse and addiction are a serious problem for public health and economy in the US. Since opioids is applied to chronic non-cancer pain as well as cancer pain, chronic opioid user is increasing according to the increase in life expectancy. However, Preoperative use of opioids is a risk factor for postoperative infection and reoperation because of their immune-suppressive effects. In addition, Perioperative use of opioids can lead to chronic opioid use and cancer recurrence after surgery. The immune-suppressive effects of opioids depend on type and dose of opioids. Recently, it has been reported that opioids can inhibit immune response through pattern-recognition receptors other than opioid receptors. Therefore, the binding of opioids to pattern-recognition receptors might directly change the recognition of foreign substance including pathogen and cancer cells.