[Acidosis, hypoxia and hypotension in abdominal chemotherapy with blockade of arterial and venous circulation (stop flow)].

OBJECTIVE

A study was performed of the perioperative systemic effects of a recent zoned chemotherapy technique administered in conditions of extreme acidosis, hypoxia and modern hypotension.

METHODS

METHODS

a prospective analysis of the changes compared to basal values using Student's t test for paired data.

METHODS

Operating theatres and Recovery room.

METHODS

A population of 16 consenting patients suffering from abdominal or pelvic neoplasms, ASA 1-3, recruited according to the parameters suggested by the international literature.

METHODS

central venous catheter, radial arterial catheter, open catheter of the e.v. femoral artery, general anesthesia using isoflurane. Tests performed: Blood gas analysis of systemic arteries, abdominal veins and the superior vena cava at times preceding clamping (T0) and 7 and 14 mins after the start, at declamping, on reawakening from anesthesia and 30 and 60 mins afterwards (T1, T2, T3, T4, T5, T6). Serial evaluation of activated coagulation time.

RESULTS

Mean 25% reduction of neoplastic mass, systemic arterial and venous pH diminished at T1 and T2, but more marked and transient at T3; district venous pH significantly diminished during entire Stop-Flow. Systemic PaO2 increased throughout method (SaO2 > 98%). PaO2 in the superior vena cava recorded significantly higher intraoperative values compared to basal and postoperative levels, no major differences found at time T3. SaO2 showed statistically significant differences between the superior vena cava and the abdominal distrist at both T 1 (p 0.0002) and T2 (p 0.004). No toxic effects due to NPS were observed.

CONCLUSIONS

This is a safe technique but not without risks, which requires considerable anesthesiological commitment.