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Oral ketamine administration for radiation therapy in children

Erdal Dogan, Abdulmenap Güzel, Seyit Burhanedtin Zincircioglu, Mehmet Serif Arslan, Feyzi Çelik, Mehmet Besir Yildirim, Zeynep Baysal Yildirim, Mahir Kuyumcu

Background: Radiotherapy is a reliable and effective treatment for various malignancies and can be used for both curative and palliative/prophylactic ends. In order to achieve accuracy, reliability and success in the implementation of radiotherapy, it is imperative that patients adapt to the treatment and remain motionless.

Material and Methods: In this study, the records of anesthetic agents utilized in 26 patients aged 2-10 being treated by external beam radiotherapy were examined.

Results: Radiotherapy under anesthesia was implemented in a total of 56 sessions conducted on 26 patients. During the radiotherapy applications, only 10 (17%) sessions required the use of an extra dose of ketamine. The radiotherapy session duration was 6.3 ± 2.4 minutes. (The anesthesia start time was 20.5 ± 4.6.) Additionally, the patients' recovery time from anesthesia was found to be 68.6 ± 6.2. 61.5% of the patients were administered prophylactic cranial radiotherapy due to acute lymphoblastic leukaemia (ALL). Before and after the procedure, hemodynamic and respiratory parameters were found to be stable.

Conclusion: Since a combination of oral ketamine and midazolam provides effective sedation and comfort and can be administrated easily, we believe that it can be safely used in radiotherapy procedures on children.