الفهرس 
Title : Epidural Vs. ultrasound guided femoral and sciatic block in peri-operative anesthetic management for lower limb-sparing surgery in adult cancer patients . A randomized comparative study.
ContentOnly 14 pages are availabe for public view
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Abstract
Studies suggest that regional anesthesia (RA) may reduce local cancer recurrence or distant metastasis after primary excision as they avoid the usage of inhalational anesthetics during general anesthesia which may contribute to peri-operative immune-suppression. Volatile anesthetics increase tumor metastasis by suppression of natural killer (NK) cell activity. Isoflurane and sevoflurane have been shown to induce apoptosis in human T-lymphocytes in vitroin a dose-dependent manner. A recent review suggested that volatile anesthetics up regulate hypoxia-inducible factor (HIF-1Ü) in neoplastic cells, which increases angiogenesis and is associated with poor patient prognosis. (2): Previous studies were done to compare epidural anesthesia (EA) with combined femoral and sciatic nerve block (FSNB) for knee replacement surgeries. Combined femoral and sciatic blocks offer a practical alternative to epidural analgesia for unilateral knee replacement.(3): This study is designed to compare the benefits of combined femoral and sciatic nerve block with epidural blockade forperi-operative pain management for PPLS in cancer patients undergoing LLSS as removal of osteosarcoma and removal