Research Article
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Comparison of sevoflurane insufflation and intravenous ketamine use in terms of failure rate in consecutive paediatrıc radiotherapy sessions: a cross-over study

Year 2023, Volume: 4 Issue: 5, 591 - 595, 27.10.2023
https://doi.org/10.47582/jompac.1360185

Abstract

Aim: Childhood cancers are often treated with radiotherapy. During radiation therapy, sedation is often required for immobilization, especially for young children and patients with mental disabilities. Our study aimed to compare the efficacy of sevoflurane insufflation and intravenous ketamine for sedation during pediatric radiotherapy.
Materials and methods: This prospective, randomized, cross-over study was conducted between August and December 2020 on pediatric patients (1 month to 18 years) requiring sedation or general anesthesia for radiotherapy. 352 repeated sessions were conducted in the study involving 18 patients who participated. Two groups were categorized by session: ketamine (Group K) or sevoflurane (Group S).
Results: The study included the evaluation of 352 sessions for 18 patients Although there was no significant difference in procedure times between Group S and Group K during the sessions (p>0.05), Group K showed a significantly longer discharge time, higher failure rate, and higher score sedation scale in comparison to Group S (p<0.001).
Discussion: During radiotherapy sessions conducted outside of the operating room for children, the use of sevoflurane sedation was found to have a lower failure rate compared to intravenous sedation.

References

  • McFadyen JG, Pelly N, Orr RJ. Sedation and anesthesia for the pediatric patient undergoing radiation therapy. Curr Opin Anaesthesiol. 2011;24(4):433-438.
  • Harris EA. Sedation and anesthesia options for pediatric patients in the radiation oncology suite. Int J Pediatr. 2010;2010:870921.
  • Gourkanti B, Mulvihill D, Kalariya J, et al, eds. Anesthesiology: A Practical Approach. Springer International Publishing; 2018:255-264.
  • Uurluer G, Serin M, Açil M. Çocuk hastalarda radyoterapi sirasinda tekrarlayan sedasyon uygulamalari. Anestezi Derg. 2018;26(1):5-9.
  • Verma V, Beethe AB, LeRiger M, Kulkarni RR, Zhang M, Lin C. Anesthesia complications of pediatric radiation therapy. Pract Radiat Oncol. 2016;6(3):143-154.
  • Yalçın Çok O, Evren Eker H, Arıboğan A. Ketamine dosing for sedation during repeated radiotherapy sessions in children. Turk J Med Sci. 2018;48(4):851-855.
  • Owusu-Agyemang P, Popovich SM, Zavala AM, et al. A multi-institutional pilot survey of anesthesia practices during proton radiation therapy. Pract Radiat Oncol. 2016;6(3):155-159.
  • Ermoian R, Rossi M, Beltran C, Rampersad S. Localization, verification, and anesthesia. Pract Radiat Oncol. 2018:407-417.
  • Khurmi N, Patel P, Kraus M, Trentman T. Pharmacologic considerations for pediatric sedation and anesthesia outside the operating room: a review for anesthesia and non-anesthesia providers. Paediatr Drugs. 2017;19(5):435-446.
  • Işık B, Bora H, Yılmaz Z. On olguda radyoterapi nedeniyle tekrarlayan anestezi uygulamalarımız. Türkiye Klinikleri Tıp Bilimleri Derg. 2007;27:883-888.
  • World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194.
  • Horeczko T, Mahmoud M. Pre-sedation assessment. In: Mason MDKP, ed. Pediatric sedation outside of the operating room: a multispecialty international collaboration. Springer International Publishing; 2021:49-82.
  • Sahyoun C, Krauss BS. Physiological monitoring for procedural sedation. In: Mason MDKP, ed. Pediatric sedation outside of the operating room: a multispecialty international collaboration. Springer International Publishing; 2021:95-105.
  • Andropoulos DB. Sedation scales and discharge criteria: how do they differ? which one to choose? do they really apply to sedation? In: Mason MDKP, ed. Pediatric sedation outside of the operating room: a multispecialty international collaboration. Springer International Publishing; 2021:83-94.
  • Gomes HSdO, Gomes HdS, Sado-Filho J, Costa LR, Costa PS. Does sevoflurane add to outpatient procedural sedation in children? a randomised clinical trial. BMC Pediatrics. 2017;17(1):86.
  • Şimşek T, Gürbüz Aytuluk H, Yılmaz M, Kaynar Şimşek A, Turan Cıvraz AZ, Saraçoglu KT. Çocuk hastalarda manyetik rezonans görüntülemede sevofluran ile sedasyonun değerlendirilmesi. Kocaeli Tıp Derg. 2022;11(1):234-238.
  • Choopong LuansritisaNul M, Sirirat Rattanaarpa M, Garnphipa N, et al. Success rate compared between sevoflurane insufflation via simple oxygen mask and propofol intravenous infusion in small children undergoing MRI: a randomized controlled trial. J Med Assoc Thai. 2018;101(9):S35-S42.
  • De Sanctis Briggs V. Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane. Paediatr Anaesth. 2005;15(1):9-15.
  • Oğurlu M, Orhan ME, Bilgin F, Sizlan A, Yanarateş Ö, Yilmaz N. Efficacy of different concentrations of sevoflurane administered through a face mask for magnetic resonance imaging in children. Paediatr Anaesth. 2010;20(12):1098-1104.
  • Montes RG, Bohn RA. Deep sedation with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy. J Pediatr Gastroenterol Nutr. 2000;31(1):41-46.

Ardışık pediatrik radyoterapi seanslarında sevofluran insüflasyonu ve intravenöz ketamin kullanımının başarısızlık oranı açısından karşılaştırılması: çapraz bir çalışma

Year 2023, Volume: 4 Issue: 5, 591 - 595, 27.10.2023
https://doi.org/10.47582/jompac.1360185

Abstract

Amaç: Çocukluk çağı kanserleri sıklıkla radyoterapi ile tedavi edilir. Radyasyon tedavisi sırasında, özellikle küçük çocuklarda ve zihinsel engelli hastalarda immobilizasyon için sıklıkla sedasyon gereklidir. Çalışmamızda pediatrik radyoterapi sırasında sedasyon için sevofluran insuflasyonu ve intravenöz ketaminin etkinliğini karşılaştırmayı amaçladık.
Gereç ve yöntemler: Bu prospektif, randomize, cross-over çalışma Ağustos-Aralık 2020 tarihleri arasında radyoterapi için sedasyon veya genel anestezi gerektiren pediatrik hastalarda (1 ay-18 yaş) yürütüldü. 18 hastanın katıldığı çalışmada 352 tekrarlı seans gerçekleştirilmiştir. Seanslara göre iki grup kategorize edilmiştir: ketamin (Grup K) veya sevofluran (Grup S).
Sonuçlar: Çalışma 18 hasta için 352 seansın değerlendirilmesini içeriyordu. Seanslar sırasında Grup S ve Grup K arasında işlem süreleri açısından anlamlı bir fark olmamasına rağmen (p>0.05), Grup K, Grup S'ye kıyasla anlamlı olarak daha uzun taburcu süresi, daha yüksek başarısızlık oranı ve daha yüksek sedasyon skoru gösterdi (p<0.001).
Tartışma: Çocuklarda ameliyathane dışında yapılan radyoterapi seansları sırasında sevofluran sedasyon kullanımının intravenöz sedasyona kıyasla daha düşük başarısızlık oranına sahip olduğu bulunmuştur.

References

  • McFadyen JG, Pelly N, Orr RJ. Sedation and anesthesia for the pediatric patient undergoing radiation therapy. Curr Opin Anaesthesiol. 2011;24(4):433-438.
  • Harris EA. Sedation and anesthesia options for pediatric patients in the radiation oncology suite. Int J Pediatr. 2010;2010:870921.
  • Gourkanti B, Mulvihill D, Kalariya J, et al, eds. Anesthesiology: A Practical Approach. Springer International Publishing; 2018:255-264.
  • Uurluer G, Serin M, Açil M. Çocuk hastalarda radyoterapi sirasinda tekrarlayan sedasyon uygulamalari. Anestezi Derg. 2018;26(1):5-9.
  • Verma V, Beethe AB, LeRiger M, Kulkarni RR, Zhang M, Lin C. Anesthesia complications of pediatric radiation therapy. Pract Radiat Oncol. 2016;6(3):143-154.
  • Yalçın Çok O, Evren Eker H, Arıboğan A. Ketamine dosing for sedation during repeated radiotherapy sessions in children. Turk J Med Sci. 2018;48(4):851-855.
  • Owusu-Agyemang P, Popovich SM, Zavala AM, et al. A multi-institutional pilot survey of anesthesia practices during proton radiation therapy. Pract Radiat Oncol. 2016;6(3):155-159.
  • Ermoian R, Rossi M, Beltran C, Rampersad S. Localization, verification, and anesthesia. Pract Radiat Oncol. 2018:407-417.
  • Khurmi N, Patel P, Kraus M, Trentman T. Pharmacologic considerations for pediatric sedation and anesthesia outside the operating room: a review for anesthesia and non-anesthesia providers. Paediatr Drugs. 2017;19(5):435-446.
  • Işık B, Bora H, Yılmaz Z. On olguda radyoterapi nedeniyle tekrarlayan anestezi uygulamalarımız. Türkiye Klinikleri Tıp Bilimleri Derg. 2007;27:883-888.
  • World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194.
  • Horeczko T, Mahmoud M. Pre-sedation assessment. In: Mason MDKP, ed. Pediatric sedation outside of the operating room: a multispecialty international collaboration. Springer International Publishing; 2021:49-82.
  • Sahyoun C, Krauss BS. Physiological monitoring for procedural sedation. In: Mason MDKP, ed. Pediatric sedation outside of the operating room: a multispecialty international collaboration. Springer International Publishing; 2021:95-105.
  • Andropoulos DB. Sedation scales and discharge criteria: how do they differ? which one to choose? do they really apply to sedation? In: Mason MDKP, ed. Pediatric sedation outside of the operating room: a multispecialty international collaboration. Springer International Publishing; 2021:83-94.
  • Gomes HSdO, Gomes HdS, Sado-Filho J, Costa LR, Costa PS. Does sevoflurane add to outpatient procedural sedation in children? a randomised clinical trial. BMC Pediatrics. 2017;17(1):86.
  • Şimşek T, Gürbüz Aytuluk H, Yılmaz M, Kaynar Şimşek A, Turan Cıvraz AZ, Saraçoglu KT. Çocuk hastalarda manyetik rezonans görüntülemede sevofluran ile sedasyonun değerlendirilmesi. Kocaeli Tıp Derg. 2022;11(1):234-238.
  • Choopong LuansritisaNul M, Sirirat Rattanaarpa M, Garnphipa N, et al. Success rate compared between sevoflurane insufflation via simple oxygen mask and propofol intravenous infusion in small children undergoing MRI: a randomized controlled trial. J Med Assoc Thai. 2018;101(9):S35-S42.
  • De Sanctis Briggs V. Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane. Paediatr Anaesth. 2005;15(1):9-15.
  • Oğurlu M, Orhan ME, Bilgin F, Sizlan A, Yanarateş Ö, Yilmaz N. Efficacy of different concentrations of sevoflurane administered through a face mask for magnetic resonance imaging in children. Paediatr Anaesth. 2010;20(12):1098-1104.
  • Montes RG, Bohn RA. Deep sedation with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy. J Pediatr Gastroenterol Nutr. 2000;31(1):41-46.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Betül GÜVEN AYTAÇ 0000-0003-4787-9350

Early Pub Date October 26, 2023
Publication Date October 27, 2023
Published in Issue Year 2023 Volume: 4 Issue: 5

Cite

AMA GÜVEN AYTAÇ B. Comparison of sevoflurane insufflation and intravenous ketamine use in terms of failure rate in consecutive paediatrıc radiotherapy sessions: a cross-over study. J Med Palliat Care / JOMPAC / jompac. October 2023;4(5):591-595. doi:10.47582/jompac.1360185

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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