Sedation and anesthesia for the pediatric patient undergoing radiation therapy

Radiation oncology is a cornerstone in the treatment of cancer in children. Although painless, there is a requirement for the child to lie still by themselves in the radiation treatment room, for multiple daily or twice daily treatments for up to 6 weeks. Anesthesia or sedation is usually necessary to achieve this in younger children. This review provides a brief update of the latest developments in radiation oncology and describes the current best practice in anesthesia for these children.

Advances in radiation therapy and the newer modality of proton beam therapy have enabled radiation oncologists to target tumors more successfully, while avoiding damage to normal tissues. Anesthesiologists are increasingly being asked to provide sedation or anesthesia to ensure a completely immobile patient during radiation therapy.

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.