Neoplasms

All Conditions

Head and Neck Neoplasms

Central Nervous System Depressants

All Drugs and Chemicals

Analgesics

Anesthetics

Ropivacaine

Propofol

Anesthetics, Local

Remifentanil

Substance P

Neurokinin A

General anaesthesia and additional regional anaesthesia (cervical plexus block) on the tumor side.

General anaesthesia with Propofol (2mg/kgKG) and Remifentanil (0,1-0,4 µg/kg/min); additional regional anaesthesia (cervical plexus block) with an long acting local anesthetic according to clinical estimation of the treating anesthetist (about 15 ml Ropivacaine 0,75% around the carotid bifurcation, 5 ml Ropivacaine in the region of Erb´s Point of the superficial cervical plexus and 10 ml Ropivacaine at the area of skin incision on the tumor side); unilateral neck dissection.

SPRANC Block group

General anaesthesia with Propofol (2mg/kgKG) and Remifentanil (0,1-0,4 µg/kg/min); additional regional Patient Control Group (no Intervention planned), general anaesthesia with Propofol (2mg/kgKG) and Remifentanil (0,1-0,4 µg/kg/min); unilateral neck dissection.

SPRANC Control group

Juergen Birnbaum, PD Dr

In the clinical trial the investigators will observe the impact of regional anesthesia in addition to a general anesthesia on the expression of substance P in patients with unilateral Head or Neck cancer undergoing unilateral Neck Dissection. The investigators will perform an unilateral regional cervical plexus block on the tumor side. The tissue of the tumor side will be analysed by immunohistology, measuring the expression of the Substance P.

Several investigations show that anesthetic procedures, and especially the perioperative regional anesthesia, can have a benefit for patients undergoing tumor surgery.The perioperative regional anesthesia might reduce the immunological response and therefore lower the risk of tumor relapse. Factors that might play a role in tumor relapse are various, so more prospective and randomised trials are necessary to investigate the underlying mechanisms.

In a retrospective analysis by Merquiol et al. it was shown that an cervical epidural anesthesia was associated with an extended tumorfree timeline of larynx and hypopharynx carcinoma.

Supporting results could be seen in a study by Munoz et al. performing regional anaesthesia in breast cancer patients.

Taking all these facts into consideration the investigators believe that performing regional aneasthesia could reduce the relapse of larynx carcinoma. The relapse of carcinoma is believed to be linked to substance P and the neurokinin 1 (NK-1) receptor .

It is accepted that an additional regional anesthesia could reduce the impact of substance P to gain a normal immune response in the perioperative setting and to reduce the rate of tumor relapse.

Regional Anaesthesia and Substance P in Head and Neck Cancer

Influence of Regional Anaesthesia on the Expression of Substance P During Unilateral Neck Dissection Due to Head and Neck Cancer

Charite University, Berlin, Germany

Principal Investigator of the Department of Anesthesiology and Intensive Care Medicine, Charité - University Medicine Berlin

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Regional Anaesthesia and Substance P in Head and Neck Cancer	NCT03081897	Head and Neck C...	SPRANC Block gr... SPRANC Control ...	18 Years -	Charite University, Berlin, Germany
Regional Anaesthesia and Substance P in Head and Neck Cancer	NCT03081897	Head and Neck C...	SPRANC Block gr... SPRANC Control ...	18 Years -	Charite University, Berlin, Germany

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