Propofol-based balanced anesthesia is safer in pediatric radiotherapy

Abstract

Backround and purpose To investigate the incidence of complications related to propofol-based anesthesia and the factors associated with complications in children with radiotherapy. Materials and methods Patients who underwent anesthesia for external beam radiotherapy between May 2013 and November 2017 were included in the study. We assessed the age/weight, sex, oncologic diagnosis, type of radiotherapy procedure, duration of anesthesia, applied agents, and complications related to anesthesia. Complications were evaluated between group I (only propofol group) and group II (propofol plus adjuvant drugs) as respiratory and cardiac. Results In 130 patients, sedation was given for 1376 radiotherapy procedures. Of these, 1274 (1140 radiation treatment sessions and 134 computed tomography simulations) in 126 patients were propofol-based and were included in the analysis. Although respiratory complications are the most common in both groups, there were no episodes of laryngospasm, broncospasm, and no use of advanced airway intervention. The rate of complication was significantly higher in only propofol anesthesia group than in patients treated with propofol plus adjuvant drugs. In the multivariate analysis, we found three factors that were significantly associated with the risk of complications: total dose of propofol (mg/kg) (p < 0.001), anesthesia with propofol alone (as compared to propofol plus adjunct agents) (p = 0.001), and diagnosis of neuroblastoma (as compared to other diagnosis) (p = 0.043). Conclusion Propofol-based anesthesia is preferred in order to minimize the rate of complications in radiotherapy anesthesia applications. The use of non-opioid adjuvants in combination with propofol to achieve a balanced anesthesia will also reduce the complications that may be encountered.

Propofol Protects against Cerebral Ischemia/Reperfusion Injury by Down-Regulating Long Noncoding RNA SNHG14

“…PPF is a short-acting intravenous anesthetic, often used for general anesthesia. 12 PPF has been reported to have a neuroprotective effect in CI/R injury. For example, PPF regulates the adenosine A2b receptor to repress excessive activation of microglia, which contributes to attenuate cerebral infarction.…”

“…PPF is a short-acting intravenous anesthetic, often used for general anesthesia . PPF has been reported to have a neuroprotective effect in CI/R injury.…”

Techniques and Complications of Anesthesia in Pediatric Radiotherapy: A Retrospective Cohort Study

“…Their findings demonstrated a negative correlation between the total propofol dose per session and the number of previous propofol-based anesthesia episodes. In addition, total intravenous anesthesia has been associated with a higher incidence of sepsis in patients with central venous access, with reported rates as high as 15% to 20% 4,12 . Factors that contribute to this increased risk of infection risk include malnutrition, chemotherapy, immunosuppression, and repeated manipulation of long-duration venous access 13 .…”

The Neurologic Complications Associated with Anesthesia in Pediatrics Treated with Radiotherapy Under Anesthesia

“…Different drugs and diverse anesthesia techniques are used for pediatrics anesthesia in radiotherapy for ensuring immobility and sedation during this procedure, such as inhalation anesthesia (17); intramuscular and intravenous methohexital (18,19); oral, intramuscular, and intravenous ketamine (19,20); intravenous thiopental (21); intravenous meperidine; intravenous midazolam, and oral chloral hydrate (22). However, in recent years, propofol has become the standard anesthesia care for radiation therapy in children (23)(24)(25). In our study, we utilized multiple techniques and drugs.…”