Anaesthetic perioperative management of patients with pancreatic cancer

Table 1 A schematic representation of the integrated management of perioperative patients undergoing surgery for pancreatic cancer

Preoperative	Intraoperative	Postoperative
Informed patient consent	Combined general and epidural analgesia	Early nasogastric tube, catheter and drain removal
Preoperative risk assessment	Prevention of surgical site infection: Antimicrobial prophylaxis Avoid hypothermia Glucose control	Early oral nutrition/glycaemic control/goal-directed fluid therapy
		Pain relief/non-opioid oral analgesia
Evaluation and optimisation of preoperative physical conditions and medications	Blood transfusion management	Intensive postoperative ambulation and prevention of venous thromboembolism
Nutritional status	Intraoperative fluid management	Intensive respiratory rehabilitation
Risk stratification, rationale for thromboprophylaxis, and recommendations	Optimisation of intraoperative ventilation Intraoperative thromboprophylaxis	Intensive postoperative management

Modified from Grade et al[10].