Anesthetic Approach to Pediatric Patients Undergoing Gammaknife Radiosurgery

Abstract

Objective: The aim of this study was to present our anesthetic experiences for pediatric gammaknife surgery (GKRS).

Methods: Eighteen patients who underwent GKRS between Jan 1997-Dec 2003 were included in the study. Detailed retrospective analysis of patients’ records was done. Age, sex, diagnosis and previous treatments were recorded. Vital functions, anesthetic drugs used, duration of procedures and complications were recorded during stereotactic framing (FR), magnetic resonance imaging (MR), digital subtraction angiography (DSA) and GKRS.

There were 11 male and 7 female patients. Mean age was 4.83±1.85 years. The study cohort consisted of 5 arteriovenous malformations, 8 glial tumours and 5 patients with other pathologies. Duration of GKRS was 36.52±17.31 min and duration of all procedures was 160.66±59.84 min. Each shot of treatment lasted between 0.37 to 19.9 min. Stereotactic framing is the only painful part of all procedure, therefore 6 of 18 patient were underwent general anesthesia during framing. These six patients were younger than 5 years old. After than all procedures were done under the controlled sedation. Bronchospasm was observed once during framing, itwas relieved without any medical intervention.

Conclusion: As a result of this study we decided that sedation might be a safe method throughout FR, MR, DSA and GKRS procedures in pediatric patients.