Propofol Based Tiva Vs. Sevoflurane Inhalation Anesthetic for Breast Cancer Surgery: A Systematic Review

Metastasis from breast cancer leads to a higher chance of death from that cancer. According to the National Cancer Institute (2018) breast cancer survival rates among all three SEER stages (localized, regional, and distant) was approximately 90% between the years 2008 and 2014. Among these patients, those with distant metastasis had a survival rate of 27% and those with regional metastasis had an 85% survival rate (American Cancer Society, 2019). When creating an individualized anesthetic plan for a patient presenting for tumor excision of breast cancer, the anesthesia provider should create a plan that l owers the risk of metastasis and increases the patient’s chance of survival. The purpose of this systematic review was to analyze which anesthetic technique, Propofol based total Intravenous Anesthesia (TIVA) or Sevoflurane based inhalation anesthetic, will elicit less immune response. A comprehensive literature review was completed using CINAHL, Medline Plus, and Pubmed Health focusing on propofol based TIVA and Sevoflurane for anesthesia maintenance for the removal of cancerous breast tumors. The PRISMA model was used to identify eligible studies. Study analysis was completed by creating study specific and data outcome tables. Critical appraisal of individual randomized control trials was performed using the Critical Appraisal Skills Programme (CASP) checklist. A cross study analysis table was also created to compare the results of all eligible studies. The findings of this systematic review determined that Propofol based TIVA increases recurrence free survival, however there is negligible differences in the immune response between Propofol based TIVA and Sevoflurane inhalation anesthetic for women undergoing surgery for breast cancer tumor excision