Parameters of anesthesia/sedation in children receiving radiotherapy

Abstract

BackgroundPrevious reports establish low risk of complications in pediatric treatments under anesthesia/sedation (A/S) in the outpatient setting. Here, we present our institutional experience with A/S by age and gender in children receiving daily proton RT.MethodsAfter Institutional Review Board approval, we reviewed our center’s records between 9/9/2004 and 6/30/2013 with respect to age and gender of A/S requirement in our pediatric patients (defined as patients ≤18 years of age).ResultsOf 390 patients treated in this era, 182 were girls. Children aged ≤3 invariably required A/S; and by age 7–8, approximately half of patients do not. For pediatric patients ≥ 12 years of age, approximately 10% may require A/S for different reasons. There was no difference by gender.ConclusionsBeyond age 3, the requirement for A/S decreases in an age-dependent fashion, with a small cadre of older children having difficulty enough with sustained immobilization that A/S is necessary. In our experience, there is no difference in A/S requirement by gender.

Effects on adult cognitive function after neonatal exposure to clinically relevant doses of ionising radiation and ketamine in mice

“…A recent study showed that all patients 3 yr and around half those aged 7e8 yr were either sedated or under general anaesthesia during radiotherapy. 4 Ketamine is commonly used for anaesthesia during paediatric neurosurgery 5 and is also used as an effective analgesic or sedative agent. 5e7 There is a specifically vulnerable period during the foetal/ new-born brain development, characterized by synaptogenesis, dendritic arborization, extensive myelinization and biochemical changes, called the 'brain growth spurt' (BGS).…”

Modification of a modulated arc total body irradiation technique: Implementation and first clinical experience for paediatric patients

“…Although every measure is taken to eliminate the use of daily anaesthesia, at times it is required. From the literature, GA is advised for patients less than three years of age …”

Age as a decisive factor in general anesthesia use in pediatric proton beam therapy.

“…However, since it is necessary to perform this procedure several times every day, it is important to properly select subjects considering the risks. On the other hand, while several researchers have reported on the safety and efficacy of general anesthesia during PBT, there is a lack of evidence on the safety of repeated anesthesia and sedation during PBT in children (9)(10)(11). The reports lack information on the equipment standards used for safe general anesthesia management, and there was not enough information on how treatment choices were made at each facility.…”