Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) represents one of the most complex and physiologically demanding procedures encountered in modern perioperative medicine. In this episode of Anesthesia Alchemy: Lynn & Garry Unplugged, Garry takes listeners on a deep dive into the anesthetic management of these challenging cases. Rather than a checklist approach, this conversation walks through how to think during a HIPEC case—understanding the phases, recognizing evolving physiology, and staying ahead of rapid changes. Here’s some of what you’ll hear in this episode: 🔥 HIPEC creates controlled physiologic stress 🧠 Anticipation matters more than reaction 💧 Precision fluid management is critical 🌡️ Temperature swings must be managed actively 🔄 Physiology is constantly evolving   Join Sharon at the Nurse Anesthesia Update in the Bahamas: https://www.nurseanesthetist.com/events/nurse+anesthesia+update+2026/ Visit us online: https://beyondthemaskpodcast.com/ The 1099 CRNA Institute: https://aana.com/1099 Want to get CE Credit for listening? Go here: https://beyondthemaskpodcast.com/special-announcement-ce-credt/ Now you can watch the show on YouTube! Check it out here: https://www.youtube.com/channel/UCknrmkRxiwtYk7LUjSV6wmw?sub_confirmation=1