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Oral ketamine for radiotherapy in children with cancer
S Shewale1, A Saxena, A Trikha
1Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi.
Insights
Oral ketamine is less effective for sedating children during radiotherapy compared to injections. Longer onset and recovery times, along with movement issues, make it unsuitable for pediatric cancer patients requiring radiation therapy.
Area of Science:
- Pediatric Oncology
- Pain Management
- Radiotherapy
Background:
- Repeated injections for sedation during pediatric radiotherapy cause significant distress to children and parents.
- Alternative sedation methods are needed to improve the patient experience during cancer treatment.
Purpose of the Study:
- To evaluate the efficacy of oral ketamine as a sedative for children undergoing radiotherapy (RT).
- To compare oral ketamine sedation with intramuscular ketamine for pediatric cancer patients receiving RT.
Main Methods:
- Prospective study involving 10 children receiving oral ketamine (8-15 mg/kg) for 49 RT sittings.
- Comparison group: 8 children receiving intramuscular ketamine (6 mg/kg) for 28 RT sittings.
- Evaluated parameters: onset time, recovery time, sedation efficacy, and abnormal movements.
Main Results:
- Oral ketamine showed significantly longer onset and recovery times compared to intramuscular administration (p < 0.001).
- Limb movements in the oral ketamine group required additional sedation and interrupted RT.
- Sedation efficacy was compromised, leading to treatment interruptions.
Conclusions:
- Oral ketamine is not an effective sedative for radiotherapy in pediatric oncology patients.
- The drawbacks, including prolonged sedation and movement disturbances, discourage its use in this setting.
- Intramuscular ketamine remains a more viable option for sedation during pediatric radiotherapy.
Abstract:
Children coming for radiotherapy under sedation usually get repeated injections, which cause distress to both the child and the parents. A prospective study was conducted to evaluate the efficacy of oral ketamine for sedation for radiotherapy (RT) in children with cancer. Ten children who received 49 sittings of RT were given 8-15 mg/kg body weight of oral ketamine. The onset time, recovery time, efficacy of sedation and incidence of abnormal movements were compared with another group of 8 children, who received intramuscular ketamine in the dose of 6 mg/kg for a total of 28 sittings of RT. Onset time and recovery time were significantly longer in oral ketamine group as compared to the intramuscular group (p < 0.001). Limb movements in patients receiving oral ketamine necessitated further supplement of sedation and interruption of RT. These drawbacks discourage use of oral ketamine as a good sedative for radiotherapy treatment in paediatric oncology patients.