Practical considerations for intraoperative anesthesia in patients undergoing surgery in combination with hyperthermic intraperitoneal perfusion chemotherapy – a series of 60 cases
Affiliation and adress for correspondence

1 Oddział Anestezjologii i Intensywnej Terapii, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie w Warszawie
2 Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie w Warszawie
Correspondence to: Dr n. med. Małgorzata Symonides, Oddział Anestezjologii i Intensywnej Terapii, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, ul. Roentgena 5, 02-781 Warszawa, e-mail: symonides@coi.waw.pl
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2013, 11 (4), p. 255–263
DOI: 10.15557/CGO.2013.0023
ABSTRACT

The use of hyperthermic intraperitoneal perfusion chemotherapy has allowed to significantly improve treatment outcomes in patients with cancer dissemination within the peritoneal cavity. The hyperthermic intraoperative chemotherapy is based on a significantly enhanced efficacy of oncolytic drugs when acting at a temperature of 42–43°C. The paper presents an accurate description of intraoperative anesthetic management in patients undergoing hyperthermic intraperitoneal chemotherapy (HIPEC). The suggested management method was developed based on literature data as well as own clinical observations. Particular emphasis was placed on the maintenance of normovolemia as well as on the necessity of extended hemodynamic monitoring during procedures, with particular emphasis on the hyperthermic stage. A total of 60 (56 females, 4 males) anesthetic procedures for surgeries involving the use of hyperthermic intraoperative chemotherapy were performed between April 2012 and November 2013 in The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology in Warsaw. Standardized anesthetic management based on literature data and extended with certain modifications resulting from pharmacovigilance reports as well as own experience was used in all patients anesthetized for hyperthermic intraoperative chemotherapy. The authors believe that a series of 60 cases from a single center allows to propose a standard anesthetic management in these complex surgical procedures requiring close teamwork.

Keywords: hyperthermic intraperitoneal chemotherapy (HIPEC), general anesthesia, perioperative management, ovarian cancer, intraperitoneal cancer dissemination