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Anesthesia, Pain Management, and Intensive Care in Oncologic Surgery
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Anesthesia, Pain Management, and Intensive Care in Oncologic Surgery

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Critical Care".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 1227

Special Issue Editor

Dr. Ángel Becerra-Bolaños

E-Mail Website
Guest Editor
1. Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain
2. Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
Interests: perioperative hypothermia; cardiopulmonary resuscitation; airway management; hemodynamics; respiratory medicine; pain management; acute kidney failure; human rights; palliative care; elderly; frailty

Special Issue Information

Dear Colleagues,

Recently, anesthetic management has been personalized to different oncologic surgical approaches and radiotherapy treatments to improve recovery and reduce complications. Relationships among different anesthesia techniques and cancer recurrence have been explored, as well as how anesthesia can influence morbimortality and cancer-free survival.

The aim of individualizing perioperative management has been to target outcome optimization. Current research has focused on the effects of opioid-sparing anesthesia on postoperative chronic pain as well as on the feasibility, benefits, and challenges of transitioning major oncological surgeries to outpatient settings.

Ameliorating outcomes in the ICU should also be explored, as should steps to decreasing complications. Also, determining the criteria for discontinuing intensive care, balancing patient prognosis, quality of life, and ethical implications remain challenges in clinical practice.

This Special Issue aims to gather comprehensive research on perioperative management for oncological patients, foster further discussion, and improve outcomes and quality of life.

Research may include the following areas in oncologic surgery:

  • Perioperative management of specific surgical approaches and radiotherapy treatments;
  • Enhanced recovery after oncologic surgery;
  • Anesthesia and cancer recurrence;
  • Postoperative pain;
  • Outcomes.

We encourage submissions that provide preclinical and clinical research, literature reviews, and clinical case studies that contribute to evolving practices.

I look forward to receiving your contributions.

Dr. Ángel Becerra-Bolaños
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oncology
  • cancer recurrence
  • surgery
  • radiotherapy
  • anesthesia
  • analgesia
  • enhanced recovery after surgery
  • outpatient
  • chronic pain
  • intensive care unit

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

15 pages, 1202 KiB  
Article
Cytoreductive Surgery (CS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Postoperative Evolution, Adverse Outcomes and Perioperative Risk Factors
by Lucía Valencia-Sola, Ángel Becerra-Bolaños, María Mateo-Ferragut, Virginia Muiño-Palomar, Nazario Ojeda-Betancor and Aurelio Rodríguez-Pérez
Healthcare 2025, 13(7), 808; https://doi.org/10.3390/healthcare13070808 - 3 Apr 2025
Viewed by 353
Abstract
Background: Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) increases survival in peritoneal carcinomatosis, but complications may affect the long-term prognosis. We aimed to evaluate the postoperative evolution after CS + HIPEC, the appearance of adverse outcomes, and the associated risk factors. Methods: [...] Read more.
Background: Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) increases survival in peritoneal carcinomatosis, but complications may affect the long-term prognosis. We aimed to evaluate the postoperative evolution after CS + HIPEC, the appearance of adverse outcomes, and the associated risk factors. Methods: This was a retrospective observational study evaluating clinical practice in patients undergoing CS + HIPEC from 2016 to 2023 in a tertiary-level university hospital. The pre-, intra-, and postoperative variables were collected. The postoperative evolution, the appearance of postoperative complications, and the mortality were analyzed according to the perioperative data. Results: In total, 62.3% of the patients developed some kind of complication. Renal failure was related to the length of surgery [mean difference (md) 111 min, 95% CI 11–210, p = 0.029], postoperative vasoactive support [Odds Ratio (OR) 3.4, 95% CI 1.1–10.6, p = 0.033], and non-invasive mechanical ventilation (OR 5.5, 95% CI 1.5–20.5, p = 0.007). Respiratory failure was associated with renal replacement therapies (OR 13.8, 95% CI 1.3–143.9, p = 0.006), postoperative creatinine (md 0.27 mg·dL−1, 95% CI 0.1–0.4, p = 0.001), and C-reactive protein (md 33.5 mcg·L−1, 95% CI 0.1–66.8, p = 0.049). Infectious complications were related to the length of surgery (md 84 min, 95% CI 12–156, p = 0.024), non-invasive mechanical ventilation (OR 4.4, 95% CI 1.2–16.1, p = 0.018), and renal replacement therapies (OR 11.6, 95% CI 1.1–119.6, p = 0.012). The hospital stay was longer in patients with complications (md 14.8 ± 5.5 days, 95% CI 3.8–25.8, p = 0.009). The mortality rate at 12 months was 15.6%. The mortality risk factors were the preoperative hemoglobin (md −1.7 g·dL−1, 95% CI −2.8–−0.7, p = 0.001) and creatinine (md −0.12 mg·dL−1, 95% CI −0.21–−0.04, p = 0.007) and the postoperative hemoglobin (md −1.15 g·dL−1, 95% CI 0.01–2.30, p = 0.049) and C-reactive protein (md 54.6 mcg·L−1, 95% CI 18.5–90.8, p = 0.004). Intraoperative epidural analgesia was found to be a protective factor for 12-month mortality (OR 0.25, 95% CI 0.07–0.90 p = 0.027). A multivariate analysis performed after a univariate analysis showed that the only risk factor for overall mortality was not using intraoperative epidural analgesia. Conclusions: CS + HIPEC led to a high incidence of postoperative complications, but the occurrence of complications did not seem to affect postoperative survival. Full article
(This article belongs to the Special Issue Anesthesia, Pain Management, and Intensive Care in Oncologic Surgery)
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14 pages, 736 KiB  
Article
Intrathecal Morphine in Major Abdominal and Thoracic Surgery: Observational Study
by Silvia González-Santos, Antía Osorio-López, Borja Mugabure-Bujedo, Nuria González-Jorrín, Ane Abad-Motos, Inmaculada Ruiz-Montesinos, Alejandro Herreros-Pomares and Manuel Granell-Gil
Healthcare 2025, 13(7), 761; https://doi.org/10.3390/healthcare13070761 - 28 Mar 2025
Viewed by 437
Abstract
Introduction: Optimal control of acute postoperative pain after major surgery accelerates the recovery process, shortens hospital stays, and minimizes healthcare costs. Intrathecal morphine is a simple, safe, and reliable regional technique that provides prolonged analgesia, useful in a wide variety of procedures. Materials [...] Read more.
Introduction: Optimal control of acute postoperative pain after major surgery accelerates the recovery process, shortens hospital stays, and minimizes healthcare costs. Intrathecal morphine is a simple, safe, and reliable regional technique that provides prolonged analgesia, useful in a wide variety of procedures. Materials and Methods: A retrospective observational study was conducted on patients who underwent various major abdominal or thoracic surgical procedures and were administered intrathecal morphine between January 2018 and December 2021. The primary objective was to establish the safety of the technique in terms of the incidence of early and late respiratory depression, atelectasis, the need for respiratory support, and the possible association of these complications with the presence of respiratory pathologies such as chronic obstructive pulmonary disease (COPD) or sleep apnea–hypopnea syndrome (SAHS) and obesity or smoking habit. Secondary objectives included recording the consumption of rescue intravenous (IV) morphine in the first postoperative 24 h, the incidence of PONV, and the incidence of late postoperative complications (at 90 days) such as pneumonia, readmission rates, and reoperation rates. Hospital stay and mortality were also recorded. Results: A total of 484 patients were included in the study. No patient experienced respiratory depression. Atelectasis occurred in 2.07% of patients. Respiratory support with non-invasive mechanical ventilation (NIMV) or high-flow oxygen therapy (HFOT) was required by 1.86% of patients. In total, 51% of patients required rescue IV morphine (average 6.98 mg), with a rate significantly higher in the thoracic and general surgery groups compared to urological surgery. The incidence of postoperative nausea and vomiting (PONV) was 30.37%. Regarding other secondary objectives, readmissions, reoperations, and mortality rates were significantly higher in patients undergoing urological and thoracic surgery compared to those undergoing general surgery. Conclusions: The administration of intrathecal morphine for the control of acute postoperative pain after major surgery can be considered as a safe technique that fits perfectly within the set of measures for a multimodal approach to pain management in major abdominal and thoracic surgery. Full article
(This article belongs to the Special Issue Anesthesia, Pain Management, and Intensive Care in Oncologic Surgery)
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