Local tissue infiltration with levobupivacaine is more effective than ropivacaine in reducing the postoperative pain associated with laparoscopic cholecystectomy.

Summary We inrestiguted the intra-operutive applicution of intruperitoneul perfusion of hyperthermic chemotherapy and its ejects on cardioi)ascular status and oxygen consumption and delivery in I I Key wordsAnaesthesia; intraperitoneal hyperthalamic perfusion.Intraperitoneal metastatic deposits are not an uncommon finding in patients with malignant tumours of the ovaries or the gastrointestinal tract. Systemic anticancer chemotherapy is of questionable effectiveness in patients with intraperitoneal metastatic carcinoma, while the antitumour action of hyperthermia may augment the effectiveness of anticancer drugs [I, 21. Whole-body hyperthermia alone or in combination with intravenous anticancer chemotherapy has been used for the treatment of metastatic cancer; however, this mode of therapy was associated with multiple side effects and serious complications [I-61. A regional hyperthermic technique consisting of intraperitoneal perfusion of hyperthermic chemotherapy (IPHC) applied intra-operatively has recently been introduced, in order to lessen the complications and enhance the effectiveness of the treatment.The aim of this study was to determine the magnitude of changes that may occur in cardiovascular, respiratory, electrolyte and metabolic parameters during the application of IPHC under general anaesthesia. MethodsEleven pdtients (one male and 10 female) aged between 42 and 68 years and weighing between 51 and 79 kg, physical status ASA 1 or 2, were investigated after obtaining approval from the hospital ethics committee and informed consent from each patient. All patients had advanced gastric or ovarian carcinoma with macroscopic peritoneal metastases. Four patients initially underwent laparotomy for radical resection of the primary tumour and other macroscopic metastases,, while seven patients underwent only investiga-F.

After major visceral surgery, preincisional and repeated intraoperative small-dose S(+)-ketamine added to general and epidural anesthesia causes better postoperative pain relief than general and epidural anesthesia alone.

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