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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2016

01-08-2016 | Gastrointestinal Oncology

Evaluating the Impact of Total Intravenous Anesthesia on the Clinical Outcomes and Perioperative NLR and PLR Profiles of Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Authors: Pascal Owusu-Agyemang, MD, Juan P. Cata, MD, Keith F. Fournier, MD, Acsa M. Zavala, MD, Jose Soliz, MD, Mike Hernandez, MS, Andrea Hayes-Jordan, MD, Vijaya Gottumukkala, MD

Published in: Annals of Surgical Oncology | Issue 8/2016

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Abstract

Purpose

The aim of this study was to assess the impact of total intravenous anesthesia (TIVA) on the perioperative inflammatory profile and clinical outcomes of patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS–HIPEC).

Methods

A retrospective review of patients undergoing CRS–HIPEC was performed. Patients receiving a combination of preoperative tramadol extended release (ER), celecoxib, and pregabalin, along with combined intraoperative infusions of propofol, dexmedetomidine, lidocaine, and ketamine were classified as receiving a TIVA regimen (TIVA group). The second group consisted of patients receiving volatile–opioid-based anesthesia (VO group). The neutrophil:leukocyte (NLR) and platelet: leukocyte (PLR) ratios were calculated to evaluate the perioperative inflammatory status of both groups. Length of stay (LOS) and complications of both groups were also evaluated.

Results

A total of 213 patients were included in the study—139 in the VO group and 74 in the TIVA group. No statistically significant differences were observed between the groups with regard to their postoperative inflammatory profiles, LOS, or complications by organ system; however, the incidence of renal complications was higher in the TIVA group (8.1 vs. 2.2 %) and approached statistical significance (p = 0.068).

Conclusions

In this retrospective study of patients undergoing CRS–HIPEC, the combined use of preoperative celecoxib, tramadol ER and pregabalin followed by intraoperative TIVA with infusions of propofol, dexmedetomidine, ketamine, and lidocaine was not associated with a reduction in LOS or complications by organ system. Postoperative NLR and PLR profiles were also not significantly impacted.
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Metadata
Title
Evaluating the Impact of Total Intravenous Anesthesia on the Clinical Outcomes and Perioperative NLR and PLR Profiles of Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy
Authors
Pascal Owusu-Agyemang, MD
Juan P. Cata, MD
Keith F. Fournier, MD
Acsa M. Zavala, MD
Jose Soliz, MD
Mike Hernandez, MS
Andrea Hayes-Jordan, MD
Vijaya Gottumukkala, MD
Publication date
01-08-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5176-5

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