Parameters of anesthesia/sedation in children receiving radiotherapy

Radiation Oncology

Peter A S Johnstone²  Jennifer Bratton¹  Tara Hanson³  Kevin P McMullen³ 

[1] IU Health Proton Therapy Center, Bloomington, Indiana;Department of Radiation Oncology, Moffitt Cancer Center & Research Institute, Tampa, Florida, USA;Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA

关键词: Age;    Gender;    Anesthesia requirement;    Radiotherapy;    Pediatric;   

Others  :  1139642
DOI  :  10.1186/s13014-015-0363-2

 received in 2014-06-05, accepted in 2015-02-18,  发布年份 2015

【 摘 要 】

Background

Previous reports establish low risk of complications in pediatric treatments under anesthesia/sedation(A/S) in the outpatient setting. Here, we present our institutional experience with A/S by age and gender in children receiving daily proton RT.

Methods

After Institutional Review Board approval, we reviewed our center’s records between 9/9/2004 and 6/30/2013 with respect to age and gender of A/S requirement in our pediatric patients (defined as patients ≤18 years of age).

Results

Of 390 patients treated in this era, 182 were girls. Children aged ≤3 invariably required A/S; and by age 7–8, approximately half of patients do not. For pediatric patients ≥ 12 years of age, approximately 10% may require A/S for different reasons. There was no difference by gender.

Conclusions

Beyond age 3, the requirement for A/S decreases in an age-dependent fashion, with a small cadre of olderchildren having difficulty enough with sustained immobilization that A/S is necessary. In our experience, there is no difference in A/S requirement by gender.

【 授权许可】

   
2015 McMullen et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Buchsbaum JC, McMullen KP, Douglas JG, Jackson JL, Simoneaux RV, Hines M et al.. Repetitive pediatric anesthesia in a non-hospital setting. Int J Radiat Oncol Biol Phys. 2013; 85:1296-300.
• [2]Bratton J, Johnstone PAS, McMullen KP. Outpatient management of vascular access devices in children receiving radiotherapy: Complications and morbidity. Ped Blood Cancer. In press.
• [3]Richardson D, Bruso P. Vascular access devices. J Intraven Nurs. 1993; 16:44-9.
• [4]Graham D, Keldermans M, Klemm L, Semenza N, Shafer M. Infectious complications among patients receiving home intervenaous therapy with peripheral, central, or peripherally placed central venous catheters. Am J Med. 1991; 91:3B95S-100.
• [5]Walshe L, Malak S, Eagan J, Sepkowitz K. Complication rates among cancer patients with peripherally inserted central catheters. J Clin Oncol. 2002; 20:3276-81.
• [6]Babu R, Spicer RD. Implanted vascular access devices (Ports) in children: complications and their prevention. Pediatric Surg Int. 2002; 18:50-3.
• [7]Combs SE, Kessel KA, Herfarth K, Jensen A, Oertel S, Blattmann C et al.. Treatment of pediatric patients and young adults with particle therapy at the Heidelberg Ion Therapy Center (HIT): establishment of workflow and initial clinical data. Radiat Oncol. 2012; 7:170. BioMed Central Full Text
• [8]Owusu-Agyemang P, Grosshans D, Arunkumar R, Rebello E, Popovich S, Zavala A, Williams C, Ruiz J, Hernandez M, Mahajan A, Porche V. Non-invasive anesthesia for children undergoing proton therapy. Radiother Oncol Feb 20, 2014. doi: 10.1016/j.radonc.2014.01.016. [epub ahead of print]
• [9]Kim J, Jo B, Hm O, Choi H, Lee Y. High anxiety, young age and long waits increase the need for preoperative sedatives in children. J Int Med Res. 2012; 40:1381-9.
• [10]Kain ZN, Mayes LC, O’Connor TZ, Cicchetti DV. Preoperative anxiety in children: predictors and outcomes. Arch Pediatr Adolesc Med. 1996; 150(12):1238-45.
• [11]Lee J, Lee J, Lim H, Son JS, Lee JR, Kim DC et al.. Cartoon distraction alleviates anxiety in children during induction of anesthesia. Anesth Analg. 2012; 115:1168-73.
• [12]Patel A, Schieble T, Davidson M, Tran MC, Schoenberg C, Delphin E et al.. Distraction with a hand-held video game reduces pediatric preoperative anxiety. Paediatr Anaesth. 2006; 16(10):1019-27.
• [13]Vagnoli L, Caprilli S, Robiglio A, Messeri A. Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study. Pediatrics. 2005; 116(4):e563-7.
• [14]Kain ZN, Caramico LA, Mayes LC, Genevro JL, Bornstein MH, Hofstadter MB. Preoperative preparation programs in children: a comparative examination. Anesth Analg. 1998; 87:1249-55.
• [15]Singhal M, Vincent A, Simoneaux V, Johnstone PAS, Buchsbaum JC. Overcoming the learning curve in supine pediatric proton craniospinal irradiation. J Am Coll Radiol. 2012; 9:285-7.
• [16]Johnstone PAS, Kerstiens J. Doing poorly by doing good: the bottom line of proton therapy for children. J Am Coll Radiol. 2014; 11:995-7.