Safe Anesthesia for Radiotherapy in Pediatric Oncology: St. Jude Children's Research Hospital Experience, 2004–2006

Anghelescu, Doralina L.; Burgoyne, Laura L.; Liu, Wei; Hankins, Gisele M.; Cheng, Cheng; Beckham, Penny A.; Shearer, Jack; Norris, Angela; Kun, Larry E.; Bikhazi, George B.

doi:10.1016/j.ijrobp.2007.09.044

Cited by 79 publications

(51 citation statements)

References 17 publications

(38 reference statements)

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“…Decreasing sedation use has a long-term effect on the well-being of the child and family by protecting the patient from potential physiological and cognitive deficits [2, 10, 11, 13, 19]. In addition, decreasing sedation use may have financial benefits for the institution.…”

Section: Discussionmentioning

confidence: 99%

“…Central nervous system (CNS) tumors are the most commonly diagnosed solid tumor in childhood, accounting for nearly 20 % of all pediatric cancers, with 2500 new cases treated in the USA each year [1, 2]. Radiation therapy is an effective treatment modality for many CNS tumors; however, this treatment may produce significant physical and psychosocial stress for both the child and parent [3–6].…”

Section: Introductionmentioning

confidence: 99%

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Play-based procedural preparation and support intervention for cranial radiation

Grissom

Boles

Bailey

et al. 2015

Support Care Cancer

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Purpose The primary objective of this study was to examine the relationship between play-based procedural preparation and support intervention and use of sedation in children with central nervous system (CNS) tumors during radiation therapy. The secondary objective was to analyze the cost-effectiveness of the intervention compared to costs associated with daily sedation. Methods A retrospective chart review was conducted, and 116 children aged 5–12 years met criteria for inclusion. Outcome measures included the total number of radiation treatments received, the number of treatments received with and without sedation, and the type and duration of interventions, which consisted of developmentally appropriate play, education, preparation, and distraction provided by a certified child life specialist. Results The results of univariate analyses showed that age, tumor location, and total number and duration of interventions were significantly associated with sedation use during radiation therapy. Multivariate analyses showed that, after adjustment for age, tumor location, and craniospinal radiation, a significant relationship was found between the total number and duration of the interventions and sedation use. The implementation of a play-based procedural preparation and support intervention provided by a certified child life specialist significantly reduced health-care costs by decreasing the necessity of daily sedation. Conclusions Support interventions provided by child life specialists significantly decreased both sedation use and the cost associated with daily sedation during cranial radiation therapy in children with CNS tumors. This study supports the value of the child life professional as a play-based developmental specialist and a crucial component of cost-effective healthcare.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Play-based procedural preparation and support intervention for cranial radiation

Grissom

Boles

Bailey

et al. 2015

Support Care Cancer

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“…Mason et al [11] proposed that a nurse-provided sedation protocol could become an alternative to an anesthesiologist-managed general anesthesia for pediatric interventional radiological procedures, although the pediatric population receiving sedation/anesthesia in non-OR-based settings is categorized into the highest risk and the lowest error tolerance subgroup [14,15]. GKRS is distinctive among radiological interventions in terms of long duration of surgery due to multiple patient transfers [1,2,4]. As availability and indications for GKRS are expanding in the pediatric population [16], the demand for general anesthesia is expected to increase.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, GKRS requires multimodal imaging techniques including computed tomography (CT), angiography and magnetic resonance imaging (MRI) prior to irradiation therapy with multiple transfers of the patient. It has been reported that the procedure duration is one of the significant risk factors for pediatric radiation therapy performed under general anesthesia, even though anesthesia-related complications are rare [4]. With the technological advances of GKRS, a fully automated model, Leksell Gamma Knife Perfexion (Elekta Instruments AB, Stockholm, Sweden), was introduced recently.…”

Section: Introductionmentioning

confidence: 99%

Initial Experience with the Use of Remote Control Monitoring and General Anesthesia during Radiosurgery for Pediatric Patients

et al. 2011

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The demand for general anesthesia in pediatric radiosurgery has been increasing, but the issues involved are not highlighted well in the medical literature. We developed remotely controlled monitoring and anesthesia techniques, and applied our system to three pediatric patients who underwent Gamma Knife radiosurgery with automated settings. Based on the perioperative safety management, the following issues are of considerable concern: to avoid emotional trauma associated with the treatment, to secure airway patency in a variety of head positions, and to apply all standard monitors. In this report, we describe the details of our project with a comprehensive literature review.

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“…TBI takes place on the floor, which can take its toll on the anesthesia providers' backs! A retrospective study of propofol-based anesthesia for 3833 radiation therapy procedures in 177 patients at St. Jude Children's Research Hospital in Memphis found a complication rate of 1.3% [26]. Minor airway complications were the most common.…”

Section: Figure 1 a Radiation Therapy Vaultmentioning

confidence: 99%

Sedation and anesthesia for the pediatric patient undergoing radiation therapy

McFadyen

Pelly

Orr

2011

Current Opinion in Anaesthesiology

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Safe Anesthesia for Radiotherapy in Pediatric Oncology: St. Jude Children's Research Hospital Experience, 2004–2006

Abstract: The rate of anesthesia-related complications was low (1.3%) in our study. The significant risk factors were procedure duration, total propofol dose, the use of adjunct agents with propofol, and simulation (vs. radiotherapy).

Cited by 79 publications

References 17 publications

Play-based procedural preparation and support intervention for cranial radiation

Play-based procedural preparation and support intervention for cranial radiation

Initial Experience with the Use of Remote Control Monitoring and General Anesthesia during Radiosurgery for Pediatric Patients

Sedation and anesthesia for the pediatric patient undergoing radiation therapy

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