Perioperative Considerations for Patients Treated with Bleomycin (18)

In: Bleomycin

20 Apr 2013

This renal insufficiency will not only necessitate close monitoring of fluids but may indicate enhanced bleomycin-induced pulmonary damage due to impaired elimination of the drug. Cheap Diskus Advair
Choice of anesthetic technique should be based on the location and extent of the surgical procedure. A regional technique may be considered if it allows for satisfactory surgical anesthesia with a lower FIo2 than would be required with a general anesthetic; however, there are no reports of the superiority of regional anesthesia in bleomycin-treated patients.
Anesthetic management should include continuous monitoring of oxygen saturation and intermittent arterial blood gas analysis. As there are currently no conclusive studies linking the hyperoxia used in general anesthesia to postoperative pulmonary complications, we recommend the administration of 100 percent oxygen for 1 to 4 min immediately before induction of anesthesia. After induction, a target Pa02 should be chosen and the FIo2 maintained at the lowest level which allows for adequate oxygenation. Positive end-expiratory pressure may be helpful in maintaining adequate oxygenation. Volume status should be monitored in a fashion appropriate to the extent of the surgery and the condition of the patient.

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