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Online ISSN 1827-1596
Di Filippo A., Marini F., Barneschi M. G., Falchi S., Novelli G. P.
Università degli Studi - Firenze Dipartimento Area Critica Medico-chirurgica Sezione di Anestesia e Rianimazione
Background. The so called “stop-flow” operation is based on locoregional perfusion with an antiblastic hypoxic solution of the region invaded by malignant tissue. Cardiocirculatory complications are common, mainly consisting of reduction of cardiac index, increase of arterial pulmonary pressure, systemic vascular resistance and heart rate. Sevoflurane has been used for its stable hemodynamic profile to reduce cardiocirculatory troubles.
Methods. Six patients were submitted to “stop-flow” operation. General anaesthesia was performed with Sevoflurane 1 MAC in Air/O2. The following parameters were recorded: nitroglycerin infusion in order to maintain the position of the balloon of the catheters, arterial oxygen saturation, end-tidal carbon dioxide, mean arterial pressure, central venous pressure, arterial pulmonary pressure, heart rate and mixed oxygen venous saturation; recordings were performed before “stop-flow” (T1), during “stop-flow” (T2) and 10’ after reperfusion (T3).
Results. Before “stop-flow” (T1) all the parameters were normal. At T2 heart rate, cardiac index and pulmonary capillary wedge pressure increased whilst mean arterial pressure, systemic vascular resistance and pulmonary vascular resistance decreased. Ten minutes after the end of perfusion (T3) absence of variations in systemic vascular resistance, in pulmonary vascular resistance, in pulmonary capillary wedge pressure, in cardiac index and in mixed oxygen venous saturation were noticed. Heart rate and central venous pressure showed a tendency to decrease.
Conclusions. The hemodynamic profile during “stop-flow” appears to be stable with general anaesthesia with Sevoflurane.