Use of sedation and anesthesia in the pediatrics patients undergoing radiotherap

Abstract

Background: Radiation therapy is essential for the treatment of pediatric cancer. At least half of the children who require radiation therapy will need sedation or anesthesia. It is important to know the potential complications associated with repetitive use of sedative or anesthetic medications. The objective of the study was to describe the clinical and epidemiological characteristics of patients diagnosed with cancer at the National Children's Hospital ""Dr. Carlos Sáenz Herrera"" of the Costa Rican Social Security Fund, who received sedation or anesthesia during their treatment with external radiotherapy in the period from January 2016 to June 2019.

Methods: It is an observational, descriptive and retrospective study of a series of cases. Pediatric patients diagnosed with cancer, who underwent radiotherapy treatment and who required sedation or anesthesia during that intervention were included. The statistical techniques used for the qualitative variables were simple frequency tables and association or contingency tables; quantitative variables are described using central tendency and position statistics, as well as variability.

Results: A total of 61 patients diagnosed with cancer and receiving radiotherapy were studied. 57.4% of the patients were men. 75% of patients were 4.0 years or younger. The most frequent anatomic location of the tumor was in the central nervous system. A minority (14.5%) received radiotherapy as the only treatment. 75% of patients received 30 or fewer treatment sessions under sedation or anesthesia. Propofol was administered to 100.0% of patients in all treatment sessions. The average sedation or anesthesia time was 67.9 ± 28.2 minutes. 34.4% of the patients presented respiratory or cardiovascular complications, or both, in at least one treatment session.

Conclusions: In pediatric patients diagnosed with cancer, the use of sedation and anesthesia during radiotherapy treatment was required mainly in young children and in moderate frequency, the complications of the radiation therapy were temporary and usually well tolerated, without presenting morbidity and mortality. Propofol as monotherapy turned out to have no associated complications, however, when other drugs were added, adverse effects were observed in respiratory system, the most frequent being transient oxygen desaturation.