INTRA - OPERATIVE ANESTHESIA MANAGEMENT IN PATIENTS UNDERGOING SURGICAL IRREVERSIBLE ELECTROPORATION OF THE PANCREAS, LIVER, KIDNEY, AND RETROPERITONEAL TUMORS

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MARTIN ROBERT C.G.; SCHWARTZ ERIC; ADAMS JOANN; FARAH IAN; DERHAKE BRIAN M.

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Journal: Anesthesiology and Pain Medicine Year:2015 | Volume:5 | Issue:3 Page(s): 1-8

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Title

INTRA - OPERATIVE ANESTHESIA MANAGEMENT IN PATIENTS UNDERGOING SURGICAL IRREVERSIBLE ELECTROPORATION OF THE PANCREAS, LIVER, KIDNEY, AND RETROPERITONEAL TUMORS

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Keywords

ANESTHETIC

ELECTROPORATION

TUMORS

Abstract

Background: Irreversible ELECTROPORATION (IRE) is a relatively new approach to the management of multiple types of locally advanced soft tissue TUMORS. Unique peri-procedural ANESTHETIC management is needed in the safe and effective delivery of this therapy.Objectives: This study analyzed IRE therapy in relation to ANESTHETIC management for our initial cohort and then established and validated a set of best practical guidelines for general anesthesia in patients undergoing IRE for abdominal TUMORS.Patients and Methods: An IRB-approved prospective data collection outcome protocol was utilized. This study was broken up into two cohorts as follows: the initial 38 patients (pts) undergoing IRE in which ANESTHETIC management was not defined or optimized and then a 40-pt validation cohort to establish the most efficacious ANESTHETIC protocols.Results: During IRE delivery, a deeper neuromuscular blockade is required to ensure that all retroperitoneal muscle excitation was minimized. In the initial 38-pt cohort, attempts to treat hypertension (median SBP 190, range 185-215 and median diastolic 98, range 91-115) were made with various types of anti-hypertensives with minimal-to-insufficient effects. The established inhalation was sevoflurane with an approximate median dose of 8.0 volume percentage. Analgesic management of continuous remifentanil was utilized with epidural management, which optimized HTN and tolerance to IRE therapy.Conclusions: ANESTHETIC management for IRE of soft tissue deviates from standard ANESTHETIC medical therapy in regards to depth of neuromuscular blockade and analgesic management during IRE energy delivery. However, minor modifications in anesthesia management allow for a safe and efficient patient procedure.

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APA: Copy

MARTIN, ROBERT C.G., SCHWARTZ, ERIC, ADAMS, JOANN, FARAH, IAN, & DERHAKE, BRIAN M.. (2015). INTRA - OPERATIVE ANESTHESIA MANAGEMENT IN PATIENTS UNDERGOING SURGICAL IRREVERSIBLE ELECTROPORATION OF THE PANCREAS, LIVER, KIDNEY, AND RETROPERITONEAL TUMORS. ANESTHESIOLOGY AND PAIN MEDICINE, 5(3), 1-8. SID. https://sid.ir/paper/328517/en

Vancouver: Copy

MARTIN ROBERT C.G., SCHWARTZ ERIC, ADAMS JOANN, FARAH IAN, DERHAKE BRIAN M.. INTRA - OPERATIVE ANESTHESIA MANAGEMENT IN PATIENTS UNDERGOING SURGICAL IRREVERSIBLE ELECTROPORATION OF THE PANCREAS, LIVER, KIDNEY, AND RETROPERITONEAL TUMORS. ANESTHESIOLOGY AND PAIN MEDICINE[Internet]. 2015;5(3):1-8. Available from: https://sid.ir/paper/328517/en

IEEE: Copy

ROBERT C.G. MARTIN, ERIC SCHWARTZ, JOANN ADAMS, IAN FARAH, and BRIAN M. DERHAKE, “INTRA - OPERATIVE ANESTHESIA MANAGEMENT IN PATIENTS UNDERGOING SURGICAL IRREVERSIBLE ELECTROPORATION OF THE PANCREAS, LIVER, KIDNEY, AND RETROPERITONEAL TUMORS,” ANESTHESIOLOGY AND PAIN MEDICINE, vol. 5, no. 3, pp. 1–8, 2015, [Online]. Available: https://sid.ir/paper/328517/en

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