Perioperative medicine in oncology: the role of anesthesiologists in the control of surgical morbidity

Abstract

Anesthesiologists play a decisive role in the perioperative period of cancer surgery, attempting to minimize the risk of impacts from metabolic, hormonal, immunological and hematological responses to major surgical trauma. The objective of these activities is always to implement therapeutic strategies during anesthetic procedures that reduce complications and speed up postoperative recovery, reducing hospital costs. This study describes the factors that can be related to cardiovascular, respiratory and nutritional organic dysfunctions during the preoperative stage; the influence of perioperative conduct on hypothermia during prolonged surgeries, hemorrhages, transfusions and immunosuppression; and relevant postoperative care, that prevents and reverses hypoxemia, cardiovascular dysfunctions, pulmonary complications, confused neurological states, neurogenic ileus and the treatment of pain, of all types, in the induction of disturbances that harm homeostasis. The conclusion of this review shows that the anesthesiologist is of fundamental importance in controlling morbidity in cancer surgery. The considerations mentioned here aim to update and improve the knowledge of perioperative medicine, and can be reviewed in accordance with the evolution of the technology and the practice of anesthesiology.