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Complications following sedation of paediatric oncology patients undergoing radiotherapy
A Adenipekun1, O A Soyannwo, S D Amanor-Boadu
1Department of Radiology, College of Medicine, University of Ibadan.
Insights
Sedating young children for radiotherapy can cause complications like cellulitis and pneumonia. Involving anaesthetists in radiotherapy units can improve patient safety and sedative choices.
Area of Science:
- Pediatric Oncology
- Radiotherapy
- Pharmacology
Background:
- Immobilization via sedation is crucial for pediatric radiotherapy to protect healthy tissues.
- Current sedation practices at University College Hospital, Ibadan involve parenteral/oral promethazine, diazepam, chlorpromazine, and paraldehyde.
Purpose of the Study:
- To review complications associated with sedation in children undergoing radiotherapy.
- To assess the safety and efficacy of current sedation protocols.
Main Methods:
- Retrospective review of 84 children (1 month to 6 years) who received sedation for radiotherapy.
- Analysis of sedation-related complications over a 21–28 day treatment period.
Main Results:
- 48% of children experienced sedation-related complications.
- Common complications included injection cellulitis (85.3%), injection abscess (4.87%), lower limb paresis (7.3%), and aspiration pneumonia (2.4%).
Conclusions:
- Current sedation regimens for pediatric radiotherapy are associated with significant complication rates.
- Integrating anaesthetists into radiotherapy units can enhance patient care, monitoring, and potentially reduce complications through wider sedative options.
Abstract:
Sedation is often required to achieve immobilisation of small children during radiotherapy to avoid irradiation of normal tissues during the course of treatment. At the University College Hospital, Ibadan radiotherapists provide sedation for such patients with administration of parenteral and/or oral promethazine, diazepam, chlorpromazine and paraldehyde. This retrospective review of 84 children aged 1 month to 6 years who received sedation for radiotherapy over a period of twenty-one to twenty-eight days showed that 48% had complications. These included injection cellulitis (85.3%), injection abscess (4.87%), paresis of the lower limb (7.3%), aspiration pneumonia (2.4%). Anaesthetists in developing countries should be encouraged to extend their expertise in caring and resuscitation of sedated or unconscious patients to the radiotherapy unit. This will allow for the use of a wider variety of sedative agents and better monitoring as well as minimise or eradicate complications.