Sedation and anesthesia options for pediatric patients in the radiation oncology suite

Abstract

External beam radiation therapy (XRT) has become one of the cornerstones in the management of pediatric oncology cases. While the procedure itself is painless, the anxiety it causes may necessitate the provision of sedation or anesthesia for the patient. This review paper will briefly review the XRT procedure itself so that the anesthesia provider has an understanding of what is occurring during the simulation and treatment phases. We will then examine several currently used regimens for the provision of pediatric sedation in the XRT suite as well as a discussion of when and how general anesthesia should be performed if deemed necessary. Standards of care with respect to patient monitoring will be addressed. We will conclude with a survey of the developing field of radiation-based therapy administered outside of the XRT suite.

Figure 1

The linear accelerator.

Figure 2

The simulation machine.

Figure 3

A premolded aquaplast.

Figure 4

A premolded alpha cradle.

Figure 5

Blocks used to shield radiosensitive organs.

Figure 6

A Huber needle used to access an intravascular port.

Figure 7

A remote monitor bank.

Figure 8

The gamma knife machine (courtesy of Elekta).