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2014, Number 3

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Rev Mex Anest 2014; 37 (3)

Perioperative management of hyperthermic intraperitoneal chemotherapy

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

Language: Spanish
References: 25
Page: 193-200
PDF size: 223.46 Kb.


ABSTRACT

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) has become the standard treatment for patients with tumors of the peritoneal surface. Completion of this combined procedure can last up to more than 13 hours during which alterations as hydroelectrolyte imbalance, hypovolemia, coagulopathy, changes in temperature and metabolism, as well as changes in lung function are presented. The technique for the administration of intraperitoneal therapy has its own risks, mainly cardiovascular, especially with the closed technique. The perioperative management should be individualized according to the needs of each patient and use the monitoring to adapt and optimize the mechanical ventilation, fluid replacement, coagulation and hemodynamic status. The use of combined general and regional anesthesia improves the prognosis of patients, however not all are candidates for neuraxial blockade. The aim of this review is that the anesthesiologist knows the process of HIPEC and alterations that may occur in the perioperative period to prevent and treat them in a timely manner.


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