Sedation and anesthesia for the pediatric patient undergoing radiation therapy

McFadyen, J. Grant; Pelly, Nicole; Orr, Rosemary J.

doi:10.1097/aco.0b013e328347f931

Cited by 57 publications

(33 citation statements)

References 24 publications

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“…While radiation therapy is painless, children can experience considerable anxiety due to unfamiliar and potentially frightening radiation equipment [3]. Nevertheless, children must be made motionless using anesthesia or sedation during this short procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, children must be made motionless using anesthesia or sedation during this short procedure. Propofol, ketamine, midazolam, and general anesthesia with sevoflurane have been administered as anesthetics or sedatives to pediatric patients [345]. Adverse effects, including respiratory depression and excessive sedation, may necessitate endotracheal intubation [6].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dexmedetomidine for sedation in pediatric patients who received more than 20 sessions of radiation therapy: two cases report

Kim

Song

Lee

et al. 2016

Korean J Anesthesiol

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Dexmedetomidine is a highly selective α2-adrenoceptor agonist that demonstrates anxiolytic and analgesic properties without inducing respiratory compromise, which makes it a suitable agent for procedural sedation and imaging studies. In our current case reports, intravenous dexmedetomidine infusion was used to provide sedation to 2 pediatric patients over more than 20 sessions of radiation therapy. On both occasions, dexmedetomidine provided adequate sedation without respiratory depression. However, the required dosage increased with repeated radiation therapy sessions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine for sedation in pediatric patients who received more than 20 sessions of radiation therapy: two cases report

Kim

Song

Lee

et al. 2016

Korean J Anesthesiol

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“…Similar to Alcorn et al 14, we found an extensive use of vacuum cushions (> 62%) for thoracic, abdominal and pelvic treatments. Our survey did not disclose anesthesia practices, whereas anesthesia or sedation is often required in the very young to ensure complete immobility during radiotherapy (28).…”

Section: Studymentioning

confidence: 99%

A Baseline Survey on the Treatment Workflow and Pediatric IGRT Practice Among European Members of the Project-Based Consortium and the Pediatric Radiation Oncology Society (PROS).

Windmeijer

Bel

Jong

et al. 2020

Preprint

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Background Image-guided radiotherapy (IGRT) enables high precision tumor treatment with potential for sparing healthy tissues. The value of pediatric IGRT is widely acknowledged, but there is no consensus on ‘best practice’. We aimed to assess clinical pediatric IGRT practice among European members of the Pediatric Radiation Oncology Society (PROS) and members of our project-based consortium.Methods A survey addressing radiotherapy preparation, planning and delivery in seven treatment sites was sent to European PROS members and/or our IGRT project-based consortium (70 institutes). Responses were collected from June-September 2018.Results Of the 42 responding institutes (response rate 60%), 33 indicated to treat children. 28/33 are photon-only institutes, 3/33 are dedicated proton (‘proton-only’) institutes and 2/33 use both. Immobilization includes facial masks (in 100% of brain, craniospinal axis (CSA) and head-and-neck (H&N) treatments), and vacuum cushions (all sites, except brain and H&N). Intensity-modulated radiotherapy and volumetric-modulated arc therapy are most frequently applied ranging from 71%-81% in respectively CSA (20/28), and extremities (21/26), followed by 3D conformal radiotherapy ranging from 36%-69% in respectively H&N (10/28), and extremities (18/26). Isotropic planning target volume (PTV) margins varied widely in brain and abdomen (range, 1-10mm). The use of in-room kilovolt cone-beam computed tomography ranges from 57%-86% in respectively CSA (16/28), and thorax (24/28). Daily online imaging is used by the majority of institutes, ranging from 85%-90% in respectively extremities (22/26) and pelvis (27/30). Offline imaging protocols are used by 14%-21% in respectively H&N (4/28) and thorax (6/28).Conclusions Our survey shows comparable practice in pre-treatment imaging, planning and treatment techniques, and IGRT application among the participating European institutes. However, wide ranges in PTV margin sizes exist, supporting the need to define international ‘best practice’ guidelines for pediatric IGRT, and to aim for consensus on optimal margin definitions in view of available IGRT facilities and workflows among institutes.

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“…Many departments prefer the use of a conscious sedative rather than full general anesthesia, which would require intubation. Propofol is often used due to its ease of administration and quick recovery in a majority of patients (McFadyen et al, 2011). Most children need only an oxygen mask, but a few will require a laryngeal mask airway (LMA) or nasal trumpet to maintain a good airway.…”

Section: Immobilization/anesthesiamentioning

confidence: 99%

Pediatric Radiation

Jimenez

MacDonald

2015

Craniopharyngiomas

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Sedation and anesthesia for the pediatric patient undergoing radiation therapy

Abstract: In the vast majority of cases, total intravenous anesthesia or sedation using propofol ensures that the child remains immobile, whilst maintaining spontaneous respiration, an unobstructed airway, and cardiovascular stability.

Cited by 57 publications

References 24 publications

Dexmedetomidine for sedation in pediatric patients who received more than 20 sessions of radiation therapy: two cases report

Dexmedetomidine for sedation in pediatric patients who received more than 20 sessions of radiation therapy: two cases report

A Baseline Survey on the Treatment Workflow and Pediatric IGRT Practice Among European Members of the Project-Based Consortium and the Pediatric Radiation Oncology Society (PROS).

Pediatric Radiation

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