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. 2020 Nov 17;5(4):20190013.
doi: 10.1515/pp-2019-0013. eCollection 2020 Nov.

Anaesthesia considerations and techniques for Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC)

Venkatesan Shree  1   2 , Tian Jin Lim  1   2 , Lyn Li Lean  1   2 , Bok Yan Jimmy So  3   4 , Guowei Kim  3   4
Affiliations

Anaesthesia considerations and techniques for Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC)

Venkatesan Shree et al. Pleura Peritoneum. .

Abstract

Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC) is a novel surgical technique to administer aerosolized chemotherapy into the abdominal cavity as treatment for peritoneal metastasis from various cancers. As the surgery is unique and there are concerns about occupational hazards, specific anaesthetic setup and techniques are required. Notably, our institution's experience with PIPAC has enlightened us that anaesthesia requirements during PIPAC are generally uncomplicated and that the majority of the patients undergoing PIPAC do not require invasive monitoring, advanced intra or postoperative analgesia like epidurals or PCA. The need for postoperative intensive unit care is also not required in routine PIPAC cases. We describe the anaesthetic considerations involved and the detailed preparation of staff, space, anaesthetic equipment and drugs to facilitate the appropriate modifications for anaesthesia monitoring and maintenance for an elective set up as well as our standard operating procedure for an emergency situation should it arise.

Keywords: Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC) anaesthesia considerations; anaesthesia setup; total intravenous anaesthesia (TIVA).

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Conflict of interest statement

Competing interests: Authors state no conflict of interest or affiliations.

Figures

Figure 1:
Figure 1:
Flowchart adapted from www.Resus.org.UK [10].
See this image and copyright information in PMC

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