Anaesthesia for radiation therapy – Gliwice experience

Wojcieszek, Ewa; Rembielak, Agata; Białas, Brygida; Wojcieszek, A.

doi:10.4149/neo_2010_02_155

Cited by 14 publications

(13 citation statements)

References 20 publications

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“…However, it is reasonable to assume that this would further raise the cost significantly. Further, while the rate of severe anesthetic complications is low, patients undergoing prostate brachytherapy tend to be older and thus are generally considered to be higher anesthetic risk [11,12].…”

Section: Discussionmentioning

confidence: 99%

Re-implantation following suboptimal dosimetry in low-dose-rate prostate brachytherapy: technique for outpatient source insertion using local anesthesia

Kumar

DeWeese

et al. 2015

J Radiat Oncol

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Objective The objective of this study is to describe our method and results for improvement of suboptimal initial postimplant dosimetry using targeted seed placement under local anesthesia within a clinic setting. Methods Re-implantation was performed in an outpatient clinic using local anesthesia with transrectal ultrasound (TRUS) and template-guided insertion of additional seeds in a shielded suite without general anesthesia. Patient reported discomfort is minimal, and time to complete the procedure is 30 min or less. D90 and V100 were used to measure implantation quality in both the initial and re-implantation setting. Results Ten patients were treated from October 2010 to December 2012 with additional Pd-103 seeds to improve initial post-implant dosimetry. A median of 73 seeds were placed initially (range 55-113), and a median of 3 additional seeds added later (range 2-6). Re-implantation was performed a median of 31 days after initial implantation (range 12-70). Median initial D90 was 100.2 % and initial V100 was 90.1 %. The median increase in D90 was 25.7 % (range 10.2-44.4 %), and the corresponding V100 increased by a median of 6.6 % (range 3.3-14.2 %). Median urethral D30 increased by 4.1 % (range 0.9-25 %) and rectal V100 increased by a median of 0.01 cm 3 (range 0-0.75 cm 3 ). A potential operating room cost reduction of $4000-$7000 and additional savings from general anesthesia fees is possible. Conclusions Re-implantation under local anesthesia for LDR prostate brachytherapy improves suboptimal dosimetry and avoids the risk and cost of OR/anesthesia time.

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Section: Discussionmentioning

confidence: 99%

Re-implantation following suboptimal dosimetry in low-dose-rate prostate brachytherapy: technique for outpatient source insertion using local anesthesia

Kumar

DeWeese

et al. 2015

J Radiat Oncol

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“…Although randomized controlled trials have not yet been undertaken, clinicians have shared their experiences and are attempting to identify the safest anesthesia method under these circumstances. 4,7,9,11–16…”

Section: Discussionmentioning

confidence: 99%

“…Our total complication rate (2.6%) is also similar to that found in other studies. 4,7,9,11 It is expected that differences in the anesthesia techniques used affect complication rates. Anghelescu et al., 4 who applied propofol-based anesthesia, reported a similar respiratory complication rate (1.2%) to ours (1.7%), and our cardiovascular complication rate (0.9%) was also comparable with that of the same study (0.8%).…”

Section: Discussionmentioning

confidence: 99%

“…Although propofol may cause respiratory depression, it has been the drug of preference in outpatient clinics due to its rapid onset, easy titration, rapid termination of effects, and the fact that it prevents nausea and vomiting. 4,7,11 In our outpatient clinic, propofol-based anesthesia was used in accordance with our experience, and the use of propofol allowed children with nutritional problems due to diagnosis or treatment side effects to benefit from a faster return to oral feeding after anesthesia. As a matter of fact, patients in our clinic who received propofol-based anesthesia were kept in the recovery room for a maximum of one hour and were fed within two hours of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Many different medications have been used for daily recurrent anesthesia due to RT. [7][8][9][10] Propofol, the most commonly used agent in recent years, 11 provides safe sedation, rapid awakening, and rapid discharge.…”

Section: Introductionmentioning

confidence: 99%

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Propofol-based balanced anesthesia is safer in pediatric radiotherapy

Yıldırım

Celik

Bay³

et al. 2019

J Oncol Pharm Pract

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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.

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