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

Abstract

Background: Children with brain tumors experience potential neurologic complications when are treated with radiotherapy, especially if done frequently under anesthesia. Objectives: This study aimed to evaluate the neurologic complications associated with anesthesia in pediatrics treated with radiotherapy under anesthesia. Methods: This cross-sectional study consisted of 133 pediatric patients with a brain tumor who needed anesthesia for performing radiotherapy and were referred to Omid Charity Hospital and Imam Khomeini University Hospital from 2014 to 2020 by the census. Statistical values less than 0.05 were considered significant (P < 0.05). Results: The patients were in range of 1 - 8 years, and the number of 3,208 anesthesia inductions were conducted for daily radiotherapy. Major complications such as stroke, arrhythmia, tachyphylaxis, and aspiration were not observed. There was a significant relationship between the tumor side, anesthesia, and neurologic complications (P < 0.05). No significant differences were found between demographic data (age, sex, and weight) (P > 0.05). Conclusions: Anesthesia complications in this study were slight and insignificant. Some were either due to the tumor effect on other vital organs or prior exposure to radiotherapy and chemotherapy. Thus, for providing safe anesthesia, considering the tumor effect on body organs and neurologic complications caused by it can be a great help to reduce anesthesia complications in pediatrics under radiotherapy.

The Use of Muscle Relaxants After Chemotherapy and Radiotherapy

“…Administering anesthesia to cancer patients necessitates comprehension of potential drug interactions between anesthetics and cytotoxic agents. 2 …”

“…Administering anesthesia to cancer patients necessitates comprehension of potential drug interactions between anesthetics and cytotoxic agents. 2 Patients after radio-and chemotherapy treatments suffer from physical side effects, such as fatigue, hair loss, nausea, vomiting, and weight loss, but also many problems which may significantly change the anesthesiologist's approach. The main problems of an anesthesiologist in cancer patients are as follows: cardiovascular (pericardial effusion, cardiomyopathy, arrhythmia), pulmonological (pleural effusion, atelectasis, pulmonary dysfunction), gastrointestinal (nausea, diarrhea, enterocolitis, hepatitis, liver damage), renal (acute kidney injury, chronic kidney disease, proteinuria, nephrotic syndrome), hematopoietic (anemia, granulocytopenia, thrombocytopenia, hypercoagulability), metabolic (hypoglycemia, hypercalcemia, hypocalcemia, hyperkalemia, hypertension, SIADH, Cushing syndrome), neurological (neuropathy, myasthenia, metastases in the brain and spinal cord) and oncological treatment interactions.…”

The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia

“…Regional anesthesia is the preferred method of anesthesia for lower abdominal, lower limb, urology, gynecology, and anorectal surgery [4]. Tis method's advantages include reducing patient mortality and complications, better analgesia during and after the operation, and economic superiority over general anesthesia [5]. Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure applied to kidney stone removal.…”

“…Both positions will bring about hemodynamic changes for patients, and patients with coexistent diseases such as cardiovascular disease or diabetes can cause severe complications [8]. Today, the preferred anesthesia method in these surgeries is intrathecal anesthesia, according to the observed results, compared to general anesthesia [5,8]. Ephedrine is a noncatecholamine sympathomimetic amine drug that is used intravenously.…”