Safe anesthetic management of patients undergoing a novel method of treating human hepatocellular cancer

Journal of Clinical Anesthesia
T B DoughertyS A Curley

Abstract

To evaluate the safety and efficacy of monitored anesthesia care (MAC) in patients who undergo a novel treatment for hepatocellular cancer in which procedure-related hemodynamic instability is problematic. Nonrandomized open study. University cancer center operating room. Nine patients scheduled for hepatic arterial infusion of doxorubicin with complete hepatic venous isolation and extracorporeal chemofiltration (no more than 3 procedures per patient). Hepatic venous isolation was achieved with a dual-balloon inferior vena cava catheter connected to an extracorporeal circuit containing chemofilters. Doxorubicin was infused through the hepatic artery and filtered from the venous blood, which was returned to the patient through an internal jugular venous catheter. Each patient received a bolus of propofol (200 micrograms/kg) and one of alfentanil (2 micrograms/kg) followed by simultaneous infusions of propofol and alfentanil for percutaneous placement of the catheters and operation of the extracorporeal circuit. Drug rates were varied to maintain a sedative-analgesic state of calm, comfort, minimal movement, and adequate respiratory function. Prior to circuit initiation, patients were preloaded with crystalloid. During circuit op...Continue Reading

References

Mar 1, 1990·Anesthesia and Analgesia·N R Connelly, A D Weinstock
Jan 1, 1989·Anesthesia and Analgesia·E C Welling, J Donegan
Jan 1, 1989·Anesthesiology·R S Jaffe, D Coalson
Oct 1, 1988·Anesthesiology·M E MahlaM D Moneta
Nov 1, 1982·British Journal of Anaesthesia·P S SebelA van der Haven
Dec 1, 1982·Anesthesiology·J G BovillJ Heykants
Jan 1, 1995·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Y Ding, P F White

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Citations

Mar 4, 2014·Journal of Visceral Surgery·O FacyP Ortega Deballon
Jan 1, 2016·Cardiovascular and Interventional Radiology·Mark C BurgmansArian R van Erkel
Aug 2, 2018·Biomechanics and Modeling in Mechanobiology·Nazanin MaaniVitaliy L Rayz

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