Abstract PR626

Abstract

Background & Objectives: The use of total intravenous anesthesia (TIVA) has been shown to improve recovery and lower postoperative pain scores in a number of different types of surgery. In this study we aim to examine the effects of TIVA on the postoperative pain scores after CRS with HIPEC. Materials & Methods: After Institutional Review Board approval, a retrospective review of adult patients undergoing CRS-HIPEC between November 2011 and August 2014 was performed. Patients receiving premedication with celecoxib, pregabalin, and tramadol, followed by intraoperative infusions of propofol, lidocaine, dexmedetomidine, and ketamine were classified under the TIVA-group. Patients receiving a volatile/opioid based anesthetic were classified under the volatile-opioid group (VO-group). Variables including demographics, diagnosis, postoperative pain scores (POD0, POD1, POD2),and opioid use were recorded and analyzed. Results: A total of 213 patient records where reviewed. Seventy four patients received TIVA and 139 patients received volatile (VO) anesthetics. There were no statistical differences in demographics (Table 1), cancer diagnosis (P=0.132), peritoneal carcinomatosis index (P=0.267), or type of chemotherapy agent (P=.933) used. Patients who received TIVA had statistically significant lower postoperative pain scores on the day of surgery and POD1 (Figure 1).Table 1:: Summary of Patient and Clinical Characteristics (Volatile-Opioid vs. TIVA-group)Conclusion: In patients undergoing CRS with HIPEC, the use of TIVA was associated with lower early postoperative pain scores, and less intraoperative and daily IV morphine use.