bandage-green

Pelvic Exenteration

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Lithotomy, arms extended
Time : 4+ hours (very long)
Blood Loss : Very High (500+ ml)
Post-op Pain : High (7-10)
Maintenance Paralytic : Yes
Blocks : TAP, Quadratus Lumborum, Rectus Sheath
Considerations : Arterial line, Central line, High Blood Loss, PONV, Prolonged Lithotomy / Well-Leg Compartment

Anesthetic Approaches

1GETT, Epidural
2GETT, Nerve Block
3GETT, TIVA, Propofol Drip, Remifentanil Drip
The Surgery

Exploration and the abort decision - exploratory laparotomy comes first: pelvic and para-aortic nodes, liver, hemidiaphragms and upper abdominal peritoneal surfaces are inspected, washings are taken...

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