Open AccessAn Overview of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemoperfusion for the Anesthesiologist
Author(s) -
Christopher Webb,
Paul D. Weyker,
Vivek K. Moitra,
Richard K. Raker
Publication year - 2013
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0b013e3182860fff
Subject(s) - medicine , perioperative , anesthesia , hyperthermic intraperitoneal chemotherapy , hyperthermia , surgery , intensive care medicine , cytoreductive surgery , cancer , ovarian cancer
Anesthesiologists face several perioperative challenges when patients need cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion. To adequately care for these patients, anesthesiologists must understand the goals and objectives of the operation in addition to having a basic knowledge of the chemotherapeutic drugs that are frequently used. Optimal anesthetic management of patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion requires control of a complex interplay of physiologic mechanisms, including hyperthermia, abdominal hypertension, electrolyte abnormalities, coagulopathies, increased cardiac index, oxygen consumption, and decreased systemic vascular resistance. As this surgery continues to gain popularity among oncologic surgeons, further studies that clearly define the chemistry, pharmacokinetics, pharmacodynamics, and end points of efficacy need to be performed to elucidate optimal perioperative management.