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Clinical trial of fundoscopy under general anesthesia for pediatric outpatients with retinoblastoma
Toshiyuki Saito1, Masahiro Endo, Kazuaki Hiraga
1Second Department of Anatomy, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan. toshis@nms.ac.jp
Insights
Day-care general anesthesia for fundoscopy improves pediatric retinoblastoma management. This approach reduces patient distress and allows for more effective examinations, enhancing treatment outcomes for children.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Anesthesiology
Background:
- Retinoblastoma management historically involved restrictive physical restraint for pediatric fundoscopy.
- This traditional method caused significant distress to children and limited examination efficacy.
- Family feedback prompted a re-evaluation of current retinoblastoma diagnostic procedures.
Purpose of the Study:
- To evaluate the feasibility and efficacy of day-care general anesthesia for fundoscopy in pediatric retinoblastoma patients.
- To improve the diagnostic experience for children undergoing retinoblastoma examinations.
- To establish a less distressing and more effective method for fundoscopy in pediatric oncology.
Main Methods:
- A trial was conducted involving 70 pediatric patients diagnosed with retinoblastoma.
- Day-care general anesthesia was administered specifically for the fundoscopy procedure.
- International best practices for retinoblastoma treatment were investigated prior to the trial.
Main Results:
- The trial successfully implemented day-care general anesthesia for pediatric fundoscopy.
- The new method is expected to reduce patient distress during examinations.
- This approach facilitates improved diagnostic capabilities for retinoblastoma.
Conclusions:
- Day-care general anesthesia is a viable and beneficial approach for fundoscopy in pediatric retinoblastoma.
- This method enhances patient comfort and diagnostic accuracy.
- It is anticipated to enable outpatient management and discharge for patients residing further from the hospital.
Abstract:
Retinoblastoma brings suffering, particularly to children. Formerly management during fundoscopy for children in Japan saw children's movements restricted with a blanket held by their parents or by nurses. This situation was sad, and the performance of the fundoscopy was limited because the children were crying and moving during the examination. After we received letters from the families of such children, we decided to introduce day-care general anesthesia for fundoscopy. After we investigated the current status of the treatment of retinoblastoma in leading countries, we carried out a trial of day-care general anesthesia for fundoscopy in 70 pediatric patients with retinoblastoma. We have now finished this first trial of day-care anesthesia, and we expect that discharge from hospital to places a longer distance away will be feasible.