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.
Highlights
Peritoneal carcinomatosis is associated with a very poor prognosis [1] and is generally considered for palliative symptom-relieving treatment [2]
The need for postoperative intensive unit care is 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
Summary
Peritoneal carcinomatosis is associated with a very poor prognosis [1] and is generally considered for palliative symptom-relieving treatment [2]. Other advantages include procedure repeatability, improved quality of life and lower morbidity due to decreased systemic toxicity from the drugs [7]. It is useful for patients who are not eligible for cancer reduction surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) [2]. It is normothermic and was first introduced as a palliative treatment with tumour regression and improvement in patient quality of life [1, 7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
