Znieczulenie ogólne do zabiegów radioterapii śródoperacyjnej po operacji oszczędzającej u chorych na raka piersi – doświadczenia własne

*Ewa Wojcieszek¹, Wanda Woźniakowska¹, Zofia Kołosza², Krzysztof Olejnik¹, Jerzy Wydmański³, Iwona Segiet-Nowak¹, Elżbieta Basek¹, Elżbieta Wojarska-Tręda¹, Bożena Lassota-Korba¹

Summary
Background.Intraoperative radiotherapy enables delivery of single fraction radiotherapy in the operating room immediately after surgical resection of the primary tumour. It requires general anaesthesia without direct presence of the anaesthetic team in the operating room.
Methods. We have compared cardiovascular stability, level of anaesthesia, time of absence of an anaesthesiologist in the operating room and cost of anaesthesia in 82 adult women undergoing targeted intraoperative radiotherapy. Patients were randomly divided to receive propofol/remifentanil (25) propofol/fentanyl (22), thiopentone/fentanyl/sevoflurane (29) and etomidate/fentanyl/sevoflurane anaesthesia (6). The Mann-Whitney and Wilcoxon tests were used for statistical analysis.
Results. The clinically assessed level of anaesthesia, arterial blood pressure and heart rates were similar in all groups. The cost of anaesthesia was lower in the thiopentone and etomidate groups.
Discussion and conclusion. As it has been described, the choice of the method of anaesthesia does not play an important role in intraoperative radiotherapy. Special attention should be paid to the adequacy of the monitoring system, and to vigilance during the absence of the anaesthetic team from the therapy suite.

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