Background Cancer prevalence continues to rise. In vitro and in vivo studies have demonstrated that opioid receptor agonists may be associated with poor outcomes for cancer patients. Laboratory studies have shown that opioids cause immunosuppression; tumor cell progression, recurrence and metastasis. The surgical environment further decreases immune function, causes an inflammatory response and promotes cancer cell mobilization. Anesthesia providers are in a unique position to influence postoperative outcomes. Opioid free anesthetic delivery is a growing trend amongst anesthesia providers and is supported by the literature. The purpose of this project is to compare intraoperative opioid administration rates for patients with a cancer diagnosis to those without a cancer diagnosis.

Methods • Design: Observational, retrospective, descriptive study • Regulatory: CIRC approval and IRB exemption • Dates: October 1, 2017 to September 30, 2018 • Protection of human subjects: Deidentified patient data stored in HIPPA compliant Redcap Database • Setting: Providence Sacred Heart Medical Center • Participants: Adult, non-emergent surgical patients receiving IV and inhalational anesthesia • Event rates reported as risk and relative risk (RR) calculated • Analysis: Group differences in categorical variables tested by Chi-Square

Discussion This project determined that rates of intraoperative opioid administration were similar for patients with or without a cancer diagnosis. Literature suggests the use of opioid free anesthesia should be considered for patients with a cancer diagnosis. Opioid administration is common practice. Reducing its use may provide improved short and long term outcomes. This project did not consider costs of various anesthesia techniques nor did it examine dosages of opioid administration. Future research should examine reductions in the use of opioid administration and the costs associated with the use of opioid free anesthesia