JOMPAC

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

EndNote Style
Index
Original Article
Comparison of sevoflurane insufflation and intravenous ketamine use in terms of failure rate in consecutive paediatric radiotherapy sessions: a cross-over study
Aims: 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.
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. Three hundred fifty-two repeated sessions were conducted in the study involving 18 participating patients. 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).
Conclusion: 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.


1. McFadyen JG, Pelly N, Orr RJ. Sedation and anesthesia for thepediatric patient undergoing radiation therapy. Curr OpinAnaesthesiol. 2011;24(4):433-438.
2. Harris EA. Sedation and anesthesia options for pediatric patientsin the radiation oncology suite. Int J Pediatr. 2010;2010:870921.
3. Gourkanti B, Mulvihill D, Kalariya J, et al, eds. Anesthesiology: APractical Approach. Springer International Publishing; 2018:255-264.
4. Uurluer G, Serin M, A&ccedil;il M. &Ccedil;ocuk hastalarda radyoterapisirasinda tekrarlayan sedasyon uygulamalari. Anestezi Derg.2018;26(1):5-9.
5. Verma V, Beethe AB, LeRiger M, Kulkarni RR, Zhang M, Lin C.Anesthesia complications of pediatric radiation therapy. PractRadiat Oncol. 2016;6(3):143-154.
6. Yal&ccedil;ın &Ccedil;ok O, Evren Eker H, Arıboğan A. Ketamine dosing forsedation during repeated radiotherapy sessions in children. TurkJ Med Sci. 2018;48(4):851-855.
7. Owusu-Agyemang P, Popovich SM, Zavala AM, et al. A multi-institutional pilot survey of anesthesia practices during protonradiation therapy. Pract Radiat Oncol. 2016;6(3):155-159.
8. Ermoian R, Rossi M, Beltran C, Rampersad S. Localization,verification, and anesthesia. Pract Radiat Oncol. 2018:407-417.
9. Khurmi N, Patel P, Kraus M, Trentman T. Pharmacologicconsiderations for pediatric sedation and anesthesia outsidethe operating room: a review for anesthesia and non-anesthesiaproviders. Paediatr Drugs. 2017;19(5):435-446.
10. Işık B, Bora H, Yılmaz Z. On olguda radyoterapi nedeniyletekrarlayan anestezi uygulamalarımız. T&uuml;rkiye Klinikleri TıpBilimleri Derg. 2007;27:883-888.
11. World Medical Association Declaration of Helsinki: ethicalprinciples for medical research involving human subjects. JAMA.2013;310(20):2191-2194.
12. Horeczko T, Mahmoud M. Pre-sedation Assessment. In:Mason MDKP, ed. Pediatric Sedation Outside of the OperatingRoom: A Multispecialty International Collaboration. SpringerInternational Publishing; 2021:49-82.
13. Sahyoun C, Krauss BS. Physiological Monitoring for ProceduralSedation. In: Mason MDKP, ed. Pediatric Sedation Outside of theOperating Room: A Multispecialty International Collaboration.Springer International Publishing; 2021:95-105.
14. Andropoulos DB. Sedation Scales and Discharge Criteria: HowDo They Differ? Which One to Choose? Do They Really Apply toSedation? In: Mason MDKP, ed. Pediatric Sedation Outside of theOperating Room: A Multispecialty International Collaboration.Springer International Publishing; 2021:83-94.
15. Gomes HSdO, Gomes HdS, Sado-Filho J, Costa LR, CostaPS. Does sevoflurane add to outpatient procedural sedationin children? a randomised clinical trial. BMC Pediatrics.2017;17(1):86.
16. Şimşek T, G&uuml;rb&uuml;z Aytuluk H, Yılmaz M, Kaynar Şimşek A, TuranCıvraz AZ, Sara&ccedil;oglu KT. &Ccedil;ocuk hastalarda manyetik rezonansg&ouml;r&uuml;nt&uuml;lemede sevofluran ile sedasyonun değerlendirilmesi.Kocaeli Tıp Derg. 2022;11(1):234-238.
17. Choopong LuansritisaNul M, Sirirat Rattanaarpa M,Garnphipa N, Heerungeeragon M, Apapit Laoporn M, KanithaKraiprasit R, Krongthip Sripunjan R. Success rate comparedbetween sevoflurane insufflation via simple oxygen mask andpropofol intravenous infusion in small children undergoingMRI: a randomized controlled trial. J Med Assoc Thai.2018;101(9):S35-S42.
18. De Sanctis Briggs V. Magnetic resonance imaging under sedationin newborns and infants: a study of 640 cases using sevoflurane.Paediatr Anaesth. 2005;15(1):9-15.
19. Oğurlu M, Orhan ME, Bilgin F, Sizlan A, YANARATEŞ &Ouml;,Yilmaz N. Efficacy of different concentrations of sevofluraneadministered through a face mask for magnetic resonanceimaging in children. Paediatr Anaesth. 2010;20(12):1098-1104.
20. Montes RG, Bohn RA. Deep sedation with inhaled sevofluranefor pediatric outpatient gastrointestinal endoscopy. J PediatrGastroenterol Nutr. 2000;31(1):41-46.
Volume 4, Issue 5, 2023
Page : 591-595
_Footer