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Minimizing General Anesthetic Use in Pediatric Radiation Therapy
Stephanie M Ntoukas1, Tatiana Ritchie1, Susan Awrey2
1Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Practical Radiation Oncology
|December 17, 2019
Summary
Pediatric radiation therapy (RT) can be performed without general anesthesia (GA) in most children aged 4 and older. Implementing specific interventions significantly reduces GA use in pediatric RT patients.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Anesthesiology
Background:
- General anesthetic (GA) use is common for pediatric patients undergoing radiation therapy (RT).
- Minimizing GA in children is crucial for safety and reducing healthcare costs.
- Multifaceted approaches can potentially decrease GA requirements in pediatric RT.
Purpose of the Study:
- To evaluate the effectiveness of institutional methods aimed at reducing general anesthetic (GA) use in children receiving photon radiation therapy (RT).
Main Methods:
- Retrospective review of pediatric patients treated between 2010 and 2018.
- GA defined as need for anesthetic during simulation or RT.
- Interventions included dedicated pediatric nurse, audiovisual distraction, and caregiver communication.
Main Results:
- 779 patients received 14,163 RT fractions.
- GA use decreased significantly with age: 90% (<3 yrs), 28% (3-6 yrs), 1% (7-11 yrs), <1% (≥12 yrs).
- Age 4 was a key transition point, with 56.6% of 3-year-olds needing GA vs. 29.8% of 4-year-olds.
Conclusions:
- Most children aged 4+ can receive RT without GA using targeted interventions.
- Institutional GA rates are favorable compared to existing literature.
- Pediatric RT centers should consider adopting strategies to reduce GA utilization.
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