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Anesthesia and Procedural Care for Brachytherapy

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Handbook of Image-Guided Brachytherapy

Abstract

The cornerstone to providing safe, effective anesthesia during brachytherapy is a thorough pre-procedural evaluation. An individualized anesthesia plan should be developed well in advance of any foreseen procedure to mitigate patient risk and allow ample time for changes in the anesthetic plan. In general, the indications and risks to patients receiving anesthesia for brachytherapy are similar to other procedures and established pre- and post-procedural instructions should be given, and explained to all patients. In patients deemed at high risk for thrombosis (e.g., certain cardiac dysrhythmias, prosthetic heart valve, history of deep vein thrombosis or prior thromboembolism) warfarin should be bridged with enoxaparin or low molecular weight heparin to minimize peri-procedural risk of bleeding. Premedication may be given to the patient for anxiolytics or post-procedural nausea and vomiting prophylaxis. Site-specific brachytherapy discharge instructions should be provided and red-flag symptoms should be reviewed with the patient prior to procedural discharge.

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Notes

  1. 1.

    American Society of Anesthesiologists (ASA) score is a subjective assessment of a patient’s overall health that is based on five classes (I–V). I—Patient is a completely healthy fit patient. II—Patient has mild systemic disease. III—Patient has severe systemic disease that is not incapacitating. IV—Incapacitating systemic disease threatening to life. V—Moribund patient not expected to survive 24 h.

References

  1. Gouin JP, Kiecolt-Glaser JK. The impact of psychological stress on wound healing: methods and mechanisms. Crit Care Nurs Clin North Am. 2012;24(2):201–13.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Smith D, Wilkie R, Uthman O, Jordan JL, McBeth J. Chronic pain and mortality: a systematic review. PLoS One. 2014;9(6):e99048.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Katz J, Jackson M, Kavanagh BP, Sandler AN. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain. 1996;12(1):50–5.

    Article  CAS  PubMed  Google Scholar 

  4. Sharrock NE, Cazan MG, Hargett MJ, Williams-Russo P, Wilson Jr PD. Changes in mortality after total hip and knee arthroplasty over a ten-year period. Anesth Analg. 1995;80(2):242–8.

    CAS  PubMed  Google Scholar 

  5. Indelli PF, Grant SA, Nielsen K, Vail TP. Regional anesthesia in hip surgery. Clin Orthop Relat Res. 2005;441:250–5.

    Article  PubMed  Google Scholar 

  6. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35(1):64–101.

    Article  CAS  PubMed  Google Scholar 

  7. Anesthesiologists ASo. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures. Anesthesiology. 2011;114(3):495–511.

    Article  Google Scholar 

  8. Johnson SM, Saint John BE, Dine AP. Local anesthetics as antimicrobial agents: a review. Surg Infect (Larchmt). 2008;9(2):205–13.

    Article  Google Scholar 

  9. Waring JP, Baron TH, Hirota WK, et al. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy. Gastrointest Endosc. 2003;58(3):317–22.

    Article  PubMed  Google Scholar 

  10. Horn E, Nesbit SA. Pharmacology and pharmacokinetics of sedatives and analgesics. Gastrointest Endosc Clin N Am. 2004;14(2):247–68.

    Article  PubMed  Google Scholar 

  11. Bahn EL, Holt KR. Procedural sedation and analgesia: a review and new concepts. Emerg Med Clin North Am. 2005;23(2):503–17.

    Article  PubMed  Google Scholar 

  12. Aubrun F, Mazoit JX, Riou B. Postoperative intravenous morphine titration. Br J Anaesth. 2012;108(2):193–201.

    Article  CAS  PubMed  Google Scholar 

  13. Lvovschi V, Aubrun F, Bonnet P, et al. Intravenous morphine titration to treat severe pain in the ED. Am J Emerg Med. 2008;26(6):676–82.

    Article  PubMed  Google Scholar 

  14. Horlocker TT, McGregor DG, Matsushige DK, Schroeder DR, Besse JA. A retrospective review of 4767 consecutive spinal anesthetics: central nervous system complications. Perioperative Outcomes Group. Anesth Analg. 1997;84(3):578–84.

    CAS  PubMed  Google Scholar 

  15. van der Vyver M, Halpern S, Joseph G. Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis. Br J Anaesth. 2002;89(3):459–65.

    Article  PubMed  Google Scholar 

  16. Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89–91.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of California Davis Medical Center, Comprehensive Cancer Center, 4501 X Street, G0140, Sacramento, CA, 95817, USA

    Brandon A. Dyer MD & Jyoti Mayadev MD

  2. Department of Anesthesiology and Pain Medicine, University of California, Davis Medical Center, 4150 V Street, Suite 1200 PSSB, Sacramento, CA, 95817, USA

    Alison Nielsen MD

  3. Department of Radiation Oncology, University of California, Los Angeles, 200 UCLA Medical Plaza, Suite B265, Los Angeles, CA, 90095, USA

    Mitchell Kamrava MD

Authors
  1. Brandon A. Dyer MD
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  2. Alison Nielsen MD
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  3. Mitchell Kamrava MD
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  4. Jyoti Mayadev MD
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Corresponding author

Correspondence to Jyoti Mayadev MD .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, University of California Davis Medical Center, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

    Jyoti Mayadev

  2. Department of Radiation Oncology, University of California Davis Medical Center, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

    Stanley H. Benedict

  3. Division of Brachytherapy, Gynecologic and Sarcoma Services, Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California, USA

    Mitchell Kamrava

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Dyer, B.A., Nielsen, A., Kamrava, M., Mayadev, J. (2017). Anesthesia and Procedural Care for Brachytherapy. In: Mayadev, J., Benedict, S., Kamrava, M. (eds) Handbook of Image-Guided Brachytherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-44827-5_6

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  • DOI: https://doi.org/10.1007/978-3-319-44827-5_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44825-1

  • Online ISBN: 978-3-319-44827-5

  • eBook Packages: MedicineMedicine (R0)

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