Anesthesia, ICU and Pain management

Department activities

Pre-anesthetic consultation to screen and evaluate risk factors related to the patient's situation depending on the surgery.

The safety of anesthesia relies largely on this preoperative anesthesia consultation. This consultation involves collecting information on the patient’s general condition, identifying any anesthesia risk factors, customizing the preoperative anesthetic assessment, and informing the patient on the techniques to be used during anesthesia (locoregional and/or general anesthesia). The risks are explained and the choice is made in consultation with the patient. The following can be requested and implemented during this consultation:

• Specialized consultations (cardiology, pulmonology, allergology, etc.) 
• Biological assessment, 
• Electrocardiogram 
• Pre-habilitation program (immuno-nutrition, physical fitness, iron injection, placement of catheters, etc.) 
• Pre-anesthetic visit on Day 1 for hospitalized patients, on the day of surgery for outpatient procedures 
• Anesthesia protocol for conventional and outpatient surgeries 
• Postoperative monitoring in the recovery room 
• Stay in intensive care for major surgeries 
• Specific monitoring protocols in surgical departments

In the operating suite (the operating room or recovery room), the patient is monitored constantly by specialized anesthesia and ICU specialists and anesthesia nurses. Each patient undergoing surgery under anesthesia is steadily monitored using ultra-efficient computerized monitoring techniques. 

The DARD is very committed to complying with Paris Agreements in terms of reducing CO2 emissions. If equally effective, those drugs, devices, and course of care that have the lowest environmental impact will be selected.

In addition, the anesthesia department plays a major role in various procedures:

• Venous access management:

  -Placement of short or long-term intravenous devices for chemotherapy (Vascular Access Unit)

  -Removal of long-term venous accesses upon completion of treatments

• Hypnotherapy for anxiolytic and analgesic purposes
• Participation in the Committee to Combat Nosocomial Infection (CLIN). Participation in the pain control committee (CLUD) 
• Participation in the management of blood storage (hemovigilance) 
• Supervision of numerous medical residents and externs, and international trainees 
• Clinical research work

Beating pain is a priority

Management and treatment of pain caused by cancer and treating cancer are also among this department’s priorities.

Acute postoperative pain

Pain treatment begins during surgery to ensure that the patient wakes up comfortable and pain-free. In the postoperative period, this treatment is adapted according to the patient’s needs as soon as pain is felt. Prevention of side effects such as nausea and vomiting is systematic.

Chronic pain

Cancer can cause chronic pain or residual pain requiring specific treatment. Pain management is provided by different specialists, including anesthesiologists, neurosurgeons, geriatricians, and oncologists. They provide:

• Pain management consultations
• Hospitalizations in designated beds
• Such procedures as specific catheter placement, in contact with nervous system or intra-spinal pathways
• Such surgical procedures as cementoplasty, or administration of cement between the bones. Cementoplasty helps reduce or eliminate the pain process by consolidating pre-fracture states caused by secondary cancer lesions.

Institut Curie has been awarded the CETD (Center for the Study and Treatment of Pain) certification on its two sites - in Paris and St Cloud.

Hypnotherapy 

This is a specific technique provided by a qualified anesthesiologist. A hypnosis consultation is set up at Institut Curie.

Patients receive hypnosedation for surgical procedures that are not very invasive. In this way, the side effects of general anesthesia are avoided.

Other activities of the anesthesia department include the placement of implantable chambers or intravascular arrangements carried out by all anesthetists. This procedure is usually performed under local anesthesia - and rarely under general anesthesia. These catheters allow chemotherapy to be administered safely. It is possible to administer antibiotics via this same method as well as to take blood samples. Monitoring is provided by the department for Prevention of Infectious or Thrombotic Complications.

Team