Anaesthetic implications of anticancer chemotherapy

被引:14
作者
Kvolik, S
Glavas-Obrovac, L
Sakic, K
Margaretic, D
Karner, I
机构
[1] Univ Osijek, Clin Hosp, Dept Anaesthesiol, Osijek 31000, Croatia
[2] Univ Osijek, Clin Hosp, ICU, Osijek 31000, Croatia
[3] Univ Zagreb, Clin Hosp Dubrava, Dept Nucl Med, Zagreb, Croatia
[4] Univ Zagreb, Clin Hosp Dubrava, Dept Pathophysiol, Zagreb, Croatia
[5] Univ Zagreb, Clin Hosp Dubrava, Dept Anaesthesiol, Zagreb, Croatia
[6] Univ Zagreb, Clin Hosp Dubrava, ICU, Zagreb, Croatia
[7] Univ Zagreb, Clin Hosp Dubrava, Dept Radiotherapy & Oncol, Zagreb, Croatia
关键词
ANAESTHETICS; GENERAL; ANTINEOPLASTIC AGENTS; ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; COMBINED MODALITY THERAPY; chemotherapy; adjuvant; neoadjuvant; therapy; DRUG INTERACTIONS; drug antagonism; drug synergism; RADIOTHERAPY;
D O I
10.1097/00003643-200311000-00002
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
In anaesthetic practice we deal with cancer patients who are scheduled for operations on tumours or other manifestations of malignant disease. Those patients are often debilitated and have significant weight loss accompanied with hypoproteinaemia, anaemia and coagulation disorders. Oncological patients usually present to the anaesthetist before tumour disease surgery, but they are also candidates for elective operations (e.g. hernia repair) and urgent/emergency surgery (e.g. trauma, fractures and ileus). Chemotherapeutic agents given to these patients are potentially noxious, can affect the conduct of anaesthesia and, furthermore, may aggravate the patient's condition. In this review the most commonly used cytostatic drug regimens and their common side-effects are listed. Some preclinical studies on anaesthetic and cytostatic drug metabolism and interactions are emphasized, as well as clinically relevant perioperative alterations that may affect anaesthetic management in cancer patients. An anaesthetist may have to modify a routine anaesthetic regimen in cancer patients especially if anticancer chemotherapeutics were given. Clinically silent toxic drug effects may become apparent during operation, trauma or in the early postoperative course in such patients. Altered reactions to commonly used anaesthetics in patients receiving chemotherapeutics and an impaired stress reaction may occur in such patients. Special attention must be drawn to protection against opportunistic infections.
引用
收藏
页码:859 / 871
页数:13
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