SummaryIntroductionRadiotherapy is currently used in approximately one‐third of children with cancer. Treatments are typically received as weekday outpatient appointments over 3–6 weeks. The treatment is painless but requires a still, co‐operative patient who can lie alone in set positions, facilitated by the use of immobilisation devices, for up to 1 h.MethodsWe conducted a literature search to identify relevant articles relating to radiotherapy treatment. Key search terms included: ‘radiotherapy’; ‘proton beam’; ‘photon’; ‘sedation’; ‘anaesthesia’; and ‘paediatric’. The abstracts of identified articles were assessed for relevance and their references reviewed for further relevant publications.ResultsThe requirement for anaesthesia is almost exclusively limited to younger children, who are committed to daily anaesthetics over the duration of their treatment course. Centres tend to adopt a primary anaesthetic technique of either general anaesthesia using a supraglottic airway device or deep sedation, with spontaneous ventilation maintained. A full variety of anaesthetic drugs has been used with insufficient evidence to support a standardised primary approach but an apparent global trend towards propofol by infusion for sedation. Children may become acutely unwell during their treatment course and systems for escalation of clinical care in this event are vital. Distance from the patient for staff radiation shielding, patient positioning for treatment delivery and the use of immobilisation devices may provide additional access challenges in the event of an emergency.DiscussionThe requirement for anaesthesia for paediatric radiotherapy is typically confined to younger children. Patients may be unwell, with several specific considerations related to their cancer diagnosis and the impact of various treatments including surgery and chemotherapy, in addition to the radiotherapy. A multidisciplinary team approach to all aspects of care is imperative in this group of high‐risk patients.

中文翻译：

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儿科放疗麻醉的叙述性评价


摘要简介目前约有三分之一的癌症患儿使用放射治疗。治疗通常在 3-6 周内作为工作日门诊预约接受。治疗是无痛的，但需要一个静止、合作的患者，他可以单独躺在固定的姿势上，通过使用固定装置，长达 1 小时。主要检索词包括：“放射疗法”;'质子束';'光子';'镇静';“麻醉”;和“儿科”。评估已确定文章的摘要的相关性，并审查其参考文献以进一步发表相关出版物。结果麻醉的要求几乎仅限于年幼的儿童，他们在治疗过程中致力于每天进行麻醉。中心倾向于采用一期麻醉技术，即使用声门上气道装置进行全身麻醉或深度镇静，同时保持自主通气。已经使用了各种麻醉药物，但没有足够的证据支持标准化的初级方法，但明显的全球趋势是通过输注异丙酚来镇静。儿童在治疗过程中可能会出现急性不适，在这种情况下升级临床护理的系统至关重要。在紧急情况下，工作人员进行辐射防护时与患者保持距离、实施治疗时的患者位置以及使用固定装置可能会带来额外的访问挑战。讨论儿科放疗的麻醉要求通常仅限于年幼儿童。 患者可能身体不适，除了放疗外，还有几个与癌症诊断相关的具体考虑因素，以及包括手术和化疗在内的各种治疗的影响。对于这组高危患者，必须对护理的各个方面采取多学科团队方法。