Anesthetic Approach in the Cytoreduction Surgery and Intraoperative Hyperthermic Chemotherapy

Authors

Keywords:

anesthetic protocol in cytoreduction; intraoperative chemotherapy.

Abstract

Introduction: Cytoreduction surgery associated with intraperitoneal hyperthermic chemotherapy involves a series of physiological changes that the anesthesiologist must identify and treat.

Objective: To evaluate the results of the implementation of an anesthesia protocol for cytoreduction and intraoperative chemotherapy in peritoneal carcinomatosis.

Methods: An analytical, prospective, longitudinal and analytical observational study was carried out in patients performed cytoreduction and who received intraoperative hyperthermic chemotherapy in the period from September 2019 to September 2022.

Results: The mean age was 50.5 years. 71.4 % had an ovarian tumor; of these, 50 % had a peritoneal carcinomatosis index ≤ 20. Intraoperative anesthetic complications were metabolic acidosis, accounting for 11 cases (78.6 %); followed by anemia, in 50 %, and hyperglycemia, with 42.8 %. In the immediate postoperative period, metabolic acidosis occurred in 12 cases (85.7 %). Regarding resuscitation guided by hemodynamic objectives, 50 % recorded normal mean arterial pressure and 50 % reported a decreased pressure. Of the cases, 78.6 % were volume-responsive and 28.6 % were afterload-dependent. There were no contractility-dependent patients. 64.3 % had a preoperative neutrophil-lymphocyte index ≤ 3.5; of them, 50 % had an intensive care unit stay ≤ 3 days. Postoperative stay was ≤ 7 days in 92.9 %.

Conclusions: The included subjects were mostly women at middle age. The proposed protocol proved appropriate, as it allowed that surgery be performed with few perioperative complications and short intensive care and hospital stays. The most frequent hemodynamic pattern was hypovolemic with good response to volume. The preoperative neutrophil-lymphocyte index seems to be a good predictor of postoperative results.

Keywords: anesthetic protocol in cytoreduction; intraoperative chemotherapy.

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References

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2025-12-05

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Velázquez González katia, Montalvo Moya O, Hernández González R. Anesthetic Approach in the Cytoreduction Surgery and Intraoperative Hyperthermic Chemotherapy. Rev Cub Anest Rean [Internet]. 2025 Dec. 5 [cited 2025 Dec. 9];24. Available from: https://revanestesia.sld.cu/index.php/anestRean/article/view/2193

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