THE FIRST EXPERIENCE OF ANESTHETIC MANAGEMENT OF HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY
Keywords:
hyperthermic intraperitoneal chemotherapy, HIPEC, anesthetic managementAbstract
Actuality. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has become an important therapeutic method for some patients with peritoneal surface malignancies. This aggressive multimodal treatment is complex, not only regarding surgical technique, but also regarding anesthesia. Aim. The present article represents our first experience in anesthetic care during HIPEC. Materials. We analyzed 22 HIPEC procedures performed at the University Clinic of the Odessa National Medical University for the year 2016. Results. HIPEC causes significant fluid, blood and protein losses, increased intraabdominal pressure, systemic hyperthermia, and increased metabolic rate, leading to relevant pathophysiological alterations, and therefore represents a challenge for anesthetist. An appreciation of the technical aspects and physiologic disruptions associated with intraabdominal HIPEC is critical to ensure effective anesthetic management. Conclusion. This article reviews our experience about the anesthetic management of patients undergoing HIPEC. It pinpoints strategies for perioperative monitoring as well as illustrates alterations in thermoregulation, hemodynamic, pain management, fluid balance and hemostasis.
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