Francesco Boca, M.D.
Phone. +39.011.9933018
Cancer pain significantly affects the physical, psychological and emotive components and quality of life of the individual. Although pain can be alleviated in most cases by medication or other methods, many people do not report their pain or receive inadequate treatment. Our goal is the optimisation of the pain relief through a patient-centred approach with particularly attention to quality of life, personalized care and application of the newest drugs and treatments. Surgical event is an important physiologic and psychological stressing experiences. The effect is the activation of the nervous, the cardiovascular, the metabolic and the immune systems resulting in a complex network of neural, cellular, hormonal and peptide cascades. Overactivity or underactivity of stress mediators are both detrimental, and a correct balance is critical to prevent the risk of postoperative complications and to increase survival. Besides, the HIPEC, a combined surgical and pharmacological procedure, is associated to important hemodynamic and metabolic changes caused by the blood and protein loss during surgery and by the chemotherapy toxicity. All these factors concur to increase the postoperative complications. Our task is to reduce or, better, to eliminate pain and surgical stress and to maintain the hemodynamic and metabolic homeostasis by using all available strategies and techniques. To improve our practices we participate in several multicentric studies investigating (i) the role of emoderivates for volume replacement - ALBIOS study (ALBumin Italian Outcome Sepsis study), ETPOS study (European Transfusion Practice and Outcome Study); (ii) the care and clinical outcomes for patients undergoing non-cardiac surgery - EUSOS study (European Surgical Outcome Study); (iii) the mechanical ventilation practices during general anesthesia for surgery and the dependence of intra-operative and post-operative pulmonary complications - LAS VEGAS study (Local ASsessment of VEntilatory management during General Anesthesia for Surgery).