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Analgesia for Gynecologic Oncologic Surgeries: A Narrative Review
Kaiwal Patel1, Sukhman Shergill1, Nalini Vadivelu1
1Department of Anesthesiology and Pain Medicine, Yale University School of Medicine, 333 Cedar St, TMP3, New Haven, CT 06510, Connecticut, US.
Current Pain and Headache Reports
|February 4, 2022
Summary
Optimal pain management for gynecologic cancer surgery, including cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), utilizes enhanced recovery after surgery (ERAS) protocols. Individualized multimodal analgesia is key, but chronic pain requires further research.
Area of Science:
- Oncology
- Anesthesiology
- Surgical Oncology
Background:
- Gynecologic malignancies are common worldwide.
- Effective pain management is crucial for patients undergoing surgery for these cancers.
Purpose of the Study:
- To review the current evidence on optimal perioperative pain management for gynecologic malignancies.
- Specific focus on cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
Main Methods:
- Narrative review of existing literature.
- Focus on enhanced recovery after surgery (ERAS) protocols.
- Analysis of multimodal analgesia strategies.
Main Results:
- ERAS protocols improve postoperative pain management across various gynecologic procedures.
- Neuraxial techniques and opioid-sparing multimodal analgesia are effective for CRS + HIPEC.
- Pain severity is dependent on surgical approach, necessitating individualized plans.
Conclusions:
- Individualized perioperative pain management is critical for gynecologic cancer surgery.
- ERAS protocols offer significant benefits.
- Further research is needed to address chronic pain development in these patients.
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