Background and Aims:
Improved outcome after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) led to an increasing number of these procedures. Epidural analgesia has been recommended as a strategy to reduce post-operative morbidity, regardless of higher risk of spinal haematoma.

Methods:
A retrospective analysis of analgesia regimens in patients undergoing CRS and HIPEC, in a portuguese single center, was performed between January 2015 and December 2017. Data included: demographic data, ASA classification, tumor type, peritoneal carcinomatosis index, type of analgesia performed, level of epidural, type of epidural analgesia regimens, anesthesia and surgery time, hospital and ICU admission days, chemotherapy type, morbility and mortality rates, patient satisfaction.

Results
n=22, 3 patients excluded. Mean age: 51,7years. Male:Female ratio=6:13. ASA Classification: ASA I – 5,3%; ASA II - 63,1%; ASA III – 31,6%. Mean hospitalization time: 16,7 days. Mean ICU admission: 3,84 days. Epidural catheter use: 94,7%. Mean epidural catheter time: 7,7 days. Thoracic epidural catheterization: 76,5%. Lombar epidural catheterization: 23,5%. Reoperation rate:31.6%. Death rate at 30 days: 5,3%. No epidural haematomas reported. The use of epidural analgesia was associated with lesser mortality (p<0,001), lesser time of post-operative mechanical ventilation (p=0,005) and lesser ICU admission days (p=0,004). No differences between different epidural analgesia regimens and time of ICU or hospital admission or time of post-operative ventilation.

Conclusions:
In our study, epidural analgesia was a safe and effective option in CRS and HIPEC, and was associated with shortened duration of post-operative ventilation, lesser mortality and ICU admission days.

PAIN CONTROL IN PERITONECTOMY AND HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY: A 2 YEAR RETROSPECTIVE STUDY