Anesthesia Challenges in Interventional Oncology

Abstract

Better technology and imaging has allowed image-guided cancer therapy once only performed in the traditional operating room to be performed as minimally invasive procedures in other locales. The complexity of the procedures, the level of sedation required, and the comorbidities of the patients have created a need for the anesthesia care provider’s presence. This chapter discusses the role and challenges of the anesthesiologist in interventional oncology for procedures outside the traditional operating room.

Technological advancement and movement toward closed body, minimally invasive surgery has moved interventional oncology procedures, once only performed in the operating room (OR), to nontraditional locales. Historically, patient sedation in the interventional operating room has been performed under the supervision of the interventional physician. Complex procedures and the Joint Commission on Accreditation of Healthcare Organization (JCAHO) regulations led to the anesthesiology and interventional physicians working more closely together [1]. Despite the apparent simplicity of this new relationship, working outside the main operating room can be very complex. In order for the anesthesiologist to guarantee the same level of safety for the patient, the anesthesiologist must be familiar with the procedure, the location, and the potential complications. The interventionalist must be familiar with the practice guidelines and standard of anesthesia care. This chapter provides the extensive list of issues that must be addressed before the anesthesia image-guided oncology team begins patient care as well as the unique anesthetic considerations of patients undergoing image-guided cancer therapy.