Peculiarities of anesthetic support during selective intra-arterial chemotherapy for retinoblastoma. Literature review

Relevance. The use of organ-preserving techniques has become a breakthrough in the treatment of retinoblastoma. Superselective intra-arterial chemotherapy (SIAC) belongs to the methods of local chemotherapy. It can currently be used in first-line therapy, especially for advanced unilateral tumors, and carries a lower risk for systemic toxicity. SIAC was recognized as a safe procedure with few complications. However, adverse cardiorespiratory dysfunction (CRD) such as decreased lung compliance, bradycardia and subsequent hemodynamic instability have subsequently been reported. This life-threatening condition presents as autonomic cardiorespiratory reflex or trigeminocardiac reflex. So far, no safe and effective method for their complete elimination has been found. Finding such a method is an important subject of research. Purpose of the study – to summarize current literature data on etiology, pathogenesis, diagnosis, treatment and prevention of CRD arising during SIAC. Materials and methods. We searched and analyzed the literature data in the medical information systems PubMed, Chranelibrary, Cyberleninka, Google Scholar for the last 15 years using the following key words: retinoblastoma, SIAC, CRD, cardiorespiratory reflex, anesthesia during SIAC. 25 publications met the search criteria. In addition, references to selected articles were manually screened for applicable articles that included recent reports on the development of CRD during SIAC, in addition to works of historical significance. The material is intended for a wide audience of anesthesiologists, oncologists, and ophthalmologists.