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

Area of Science:

• Oncology
• Surgical Oncology
• Anesthesiology

Background:

• Peritoneal metastasis presents a treatment challenge.
• Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC) is an emerging technique for peritoneal metastasis.
• Specific anesthetic considerations are necessary due to the unique nature of PIPAC and potential occupational hazards.

Purpose of the Study:

• To outline the anesthetic considerations for Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC).
• To describe the preparation of staff, space, equipment, and drugs for PIPAC anesthesia.
• To detail standard operating procedures for both elective and emergency PIPAC anesthesia.

Main Methods:

• Review of institutional experience with PIPAC anesthesia.
• Description of anesthetic setup, monitoring, and drug administration.
• Development of protocols for elective and emergency scenarios.

Main Results:

• Anesthesia for PIPAC is generally uncomplicated.
• Most patients do not require invasive monitoring.
• Advanced analgesia (epidurals, PCA) and postoperative intensive care are typically not needed for routine PIPAC cases.

Conclusions:

• PIPAC anesthesia can be managed safely with standard anesthetic protocols and minimal invasive monitoring.
• Careful preparation of the anesthetic team and equipment is crucial for successful PIPAC procedures.
• The described approach ensures patient safety and optimizes resource utilization in PIPAC treatment.