Anaesthetic implications and occupational safety considerations of pressurised intraperitoneal aerosol chemotherapy procedures: An Australian 5-year single-centre experience

Pressurised intraperitoneal aerosol chemotherapy is an emerging treatment for peritoneal carcinomatosis, combining aerosolised chemotherapy delivery with minimally invasive surgical techniques. This study describes anaesthetic practice, perioperative outcomes, and occupational safety considerations associated with the delivery of pressurised intraperitoneal aerosol chemotherapy, based on a 5-year, single-centre experience. A retrospective review was conducted on patients who underwent pressurised intraperitoneal aerosol chemotherapy between December 2019 and April 2025. Data included demographic information, anaesthetic techniques, perioperative complications, and occupational safety measures implemented to protect healthcare staff. The study included 38 patients who underwent a total of 66 pressurised intraperitoneal aerosol chemotherapy procedures. The median age of the patients was 51 years (range 18-88 years). The median anaesthesia duration was 132 min (range 92-235 min). Common anaesthetic techniques utilised included sevoflurane for maintenance, rocuronium for neuromuscular blockade, and sugammadex for reversal of neuromuscular blockade, along with specific monitoring protocols. No notable intraoperative complications related to anaesthesia were observed. The median hospital stay was 1 day (range 0-7 days); prolonged admissions were associated with nausea and vomiting, pain, atelectasis, hypokalaemia, and fever. Occupational safety measures, including the use of personal protective equipment and aerosol containment strategies, were implemented to reduce exposure risks during the procedure, with no reported incidents of chemotherapy exposure among healthcare personnel. Pressurised intraperitoneal aerosol chemotherapy represents a viable treatment option with manageable anaesthetic challenges and significant occupational safety considerations. Ongoing education and adherence to safety protocols, along with collaboration among multiple teams, are crucial in minimising risks to both patients and healthcare workers.