AN OBSERVATIONAL STUDY OF ANAESTHETIC MANAGEMENTS IN CHILDREN UNDERGOING RADIOTHERAPY IN A TERTIARY CANCER CARE CENTRE: A PROSPECTIVE AUDIT

As a tertiary cancer care centre, we at Tata Memorial Hospital witness a large number of pediatric oncology cases, both solid tumor and hematologic. Needless to say, cancer contributes significantly to the mortality and morbidity of pediatric patients. Most solid tumor cases require external beam radiotherapy (EBRT) at some point in their treatment course, whether with a curative or palliative intent (reduces pain, preserves organ function and maintains hollow organ lumen patency).

Anesthesia or procedural sedation may be required for the procedure depending on a variety of factors including the patient’s age, cognitive function, emotional maturity, pain, musculoskeletal deformities, treatment requirements (like the prone position), claustrophobia. Children are posted for 10-28 sessions of teletherapy or 8-10 sessions of brachytherapy. Usually, children less than 6-7 years and older children with claustrophobia require procedural sedation for radiotherapy, whereas, older children cooperate by distraction or reward.

This study will focus on the day-care anesthesia practices in pediatric RT (IV sedation/inhalational anesthesia), the outcomes, patterns of anesthesia (choice of Induction agent, route of administration, premedication, duration of procedure), recovery time, issues after patient’s discharge from the hospital, longevity of a peripheral IV access line, airway considerations (difficult airway, desaturation, laryngo-/bronchospasm, excessive secretions) in Tata Memorial Hospital, Mumbai over a period of 1 year, with interim analysis at 6 months or till 600 procedures and their outcomes are recorded, whichever is earlier.