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2014, Número 3

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Rev Mex Anest 2014; 37 (3)


Manejo perioperatorio de la quimioterapia intraperitoneal hipertérmica

Carrillo-Esper R, Nava-López JA, Romero-Sierra G, Cáñez-Jiménez C

Idioma: Español
Referencias bibliográficas: 25
Paginas: 193-200
Archivo PDF: 223.46 Kb.


RESUMEN

La cirugía de citorreducción y la quimioterapia intraperitoneal hipertérmica (HIPEC) se han convertido en el tratamiento estándar para pacientes con tumores de la superficie peritoneal. La realización de este procedimiento combinado puede prolongarse hasta por más de 13 horas durante las cuales se presentan alteraciones como desequilibrio hidroelectrolítico, hipovolemia, coagulopatía, cambios en la temperatura y metabolismo, así como alteraciones de la función pulmonar. La técnica para la administración de la terapia intraperitoneal tiene sus riesgos propios, principalmente cardiovasculares, en especial con la técnica cerrada. El manejo perioperatorio debe individualizarse de acuerdo a los requerimientos de cada paciente y utilizar el monitoreo que permita adecuar y optimizar la ventilación mecánica, la reposición hídrica, la coagulación y el estado hemodinámico. El uso de técnicas combinadas de anestesia general y regional mejora el pronóstico de los pacientes; sin embargo, no todos son candidatos a recibir un bloqueo neuroaxial. El objetivo de esta revisión es que el anestesiólogo conozca el proceso de la HIPEC y las alteraciones que se pueden presentar en el perioperatorio para prevenirlas y tratarlas de forma oportuna.


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