Recurrent anesthesia applications in pediatric radiotherapy: a retrospective observational study

Aims: Pediatric radiotherapy is used for various indications in childhood malignancies. This descriptive study aims to describe the demographic data, anesthesia method and complications of pediatric radiotherapy patients. Methods: This study was conducted retrospectively and observationally in a tertiary care center. Patients aged 18 years and younger who received anesthesia for radiotherapy were included. Data were obtained from the hospital information system and anesthesia observation forms. Demographic data, radiotherapy indication, fraction number and dose, anesthesia method, anesthetic drug and dose, patient position, complications and recovery time were analyzed. Results: 485 patients received radiotherapy and anesthesia was administered to 19 of these patients (3.91%). 3 patients were excluded due to missing data, and 16 patients received anesthesia 417 times. Patients were between the ages of 1-17 years, mean age was 4.9 years. Sedation was used in 92.3% of the procedures and general anesthesia in 7.7%. The most common indication for radiotherapy was glial tumor. The number of radiotherapy fractions ranged between 8-33 sessions, the median number of sessions was 30 and the mean number of sessions was 24.8. Treatment doses were 150-200 Gray. Complication rate was 2.87%. A statistically significant difference was found when the doses of propofol, fentanyl, midazolam used in the first and last fractions and recovery times of the patients were compared (p<0.01). Conclusion: Anesthetic management in pediatric radiotherapy requires multidisciplinary treatment due to the unique requirements of the procedure. Patients should be thoroughly re-evaluated at each session and protected from the potential for addiction.