PO-514 Can ketamine be an optimal anaesthetic drug for cancer resection? a randomisedcontrolled clinical trial

Abstract

IntroductionWe, anaethetists have been searching the optimal anaesthetic drugs for patients undergoing cancer resection. Such drugs should be expected to keep patients’ natural killer cell cytotoxicity (NKCC) higher after surgery because higher NKCC can contribute to more survival rate due to less metastatic recurrence. Several basic studies have shown that traditional anaesthetic drug, ketamine can suppress NKCC. However, few clinical studies are available on such effect of ketamine. We thus conducted this randomised clinical trial to clarify if the addition of ketamine to general anaesthesia suppress NKCC in patients undergoing radical cancer resection.Material and methodsThis randomised controlled clinical trial involving 31 patients underwent robotic radical prostatectomy was conducted in Hirosaki University hospital (Aomori, Japan). Patients received general anaesthesia using propofol and remifentanil with ketamine (ketamine group) or without ketamine (non-ketamine group). The primary outcome was the difference in NKCC between two groups. The secondary outcomes were the difference in serum interleukin (IL) 6 and tumour necrosis factor (TNF) α. Each measurement was conducted before anaesthesia, 6 hours and 24 hours after anaesthesia.Results and discussionsNKCC in both group showed a similar time course pattern; no changes 6 hours but significantly decreased 24 hours after anaesthesia. There was thus no significant difference in NKCC between two groups (p=0.91), indicating that the addition of ketamine to general anaesthesia doesn’t affect NKCC. Serum TNFα was also similar between two groups (p=0.63). In contrast, Serum IL6 was significant lower in ketamine group than in non-ketamine group (p=0.02). Increased IL6 has shown to be associated with cancer progression. We thus think that supplemental ketamine can provide attenuation of an increased IL6 as well as a favourable outcome with patients.ConclusionThe addition of ketamine can be an optimal anaesthetic option for cancer resection in a real world.