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Related Experiment Videos

Anesthesiological management during isolated liver perfusion

A Bornscheuer1, K H Mahr, K Kirchhoff

  • 1Abteilung I, Medizinische Hochschule Hannover, Germany.

Recent Results in Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer
|July 22, 1998
PubMed
Summary

Isolated hyperthermic liver perfusion (IHLP) offers a new approach for liver tumors, but requires careful anesthetic management. Safe anesthesiology and monitoring during IHLP can minimize intraoperative complications, though post-therapy toxicity signs need monitoring.

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Area of Science:

  • Oncology
  • Anesthesiology
  • Surgical Oncology

Background:

  • Systemic toxicity of anticancer agents limits treatment for irresectable hepatic metastases.
  • Isolated hyperthermic liver perfusion (IHLP) is an emerging therapy for unresectable liver tumors.
  • Potential risks include extended operation, anhepatic phase, and drug/hyperthermia-induced liver damage.

Purpose of the Study:

  • To evaluate the safety and efficacy of anesthetic management during IHLP.
  • To identify potential complications and patient risks associated with IHLP.

Main Methods:

  • Anesthetic protocol involving coinduction (midazolam/thiopentone), intubation, mechanical ventilation (PEEP), pancuronium bromide, isoflurane, fentanyl, and midazolam supplementation.
  • Use of invasive hemodynamic monitoring post-induction.

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  • Detailed preoperative patient evaluation and titration of anesthetic agents.

    • Main Results:

    • Safe anesthesiological management was achieved with elevated monitoring and complete liver isolation.
    • No major intraoperative disturbances were observed during IHLP.
    • Post-perfusion, patients experienced toxicity, with low diastolic blood pressure and loss of resistance as early indicators.

    Conclusions:

    • IHLP can be managed safely with meticulous anesthetic care and monitoring.
    • While intraoperative management is feasible, post-therapy patient compromise and toxic reactions require careful observation.