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. 2008 Jun 1;71(2):491-7.
doi: 10.1016/j.ijrobp.2007.09.044. Epub 2008 Jan 22.

Safe anesthesia for radiotherapy in pediatric oncology: St. Jude Children's Research Hospital Experience, 2004-2006

Doralina L Anghelescu  1 , Laura L Burgoyne, Wei Liu, Gisele M Hankins, Cheng Cheng, Penny A Beckham, Jack Shearer, Angela L Norris, Larry E Kun, George B Bikhazi
Affiliations

Safe anesthesia for radiotherapy in pediatric oncology: St. Jude Children's Research Hospital Experience, 2004-2006

Doralina L Anghelescu et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: To determine the incidence of anesthesia-related complications in children undergoing radiotherapy and the associated risk factors.

Methods and materials: We retrospectively investigated the incidence and types of anesthesia-related complications and examined their association with age, weight, oncology diagnosis, type of anesthetic (propofol vs. propofol and adjuncts), total propofol dose, anesthetic duration, type of radiotherapy procedure (simulation vs. radiotherapy) and patient position (prone vs. supine).

Results: Between July 2004 and June 2006, propofol was used in 3,833 procedures (3,611 radiotherapy sessions and 222 simulations) in 177 patients. Complications occurred during 49 anesthetic sessions (1.3%). On univariate analysis, four factors were significantly associated with the risk of complications: procedure duration (p <0.001), total propofol dose (p <0.001), use of adjunct agents (vs. propofol alone; p = 0.029), and simulation (vs. radiotherapy; p = 0.014). Patient position (prone vs. supine) was not significantly associated with the frequency of complications (odds ratio, 0.71; 95% confidence interval, 0.33-1.53; p = 0.38). On multivariate analysis, the procedure duration (p <0.0001) and total propofol dose (p < or =0.03) were the most significant risk factors after adjustment for age, weight, anesthetic type, and procedure type. We found no evidence of the development of tolerance to propofol.

Conclusion: The rate of anesthesia-related complications was low (1.3%) in our study. The significant risk factors were procedure duration, total propofol dose, the use of adjunct agents with propofol, and simulation (vs. radiotherapy).

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Conflict of interest statement

Conflict of interest notification: There are no conflicts of interest

Figures

Figure 1
Figure 1
Individual profiles with average trend line for total dose (mg/kg)
See this image and copyright information in PMC

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