Menache L, Eifel P J, Kennamer D L, Belli J A
Department of Radiation Therapy, University of Texas Medical Branch, Galveston 77550.
Int J Radiat Oncol Biol Phys. 1990 Mar;18(3):625-9. doi: 10.1016/0360-3016(90)90070-z.
Four children ranging in age from 6-30 months were treated with twice-daily (BID) radiation therapy under general anesthesia with a 5-6 hr treatment interval. Anesthesia was accomplished with sodium thiopental administered intravenously (IV) by bolus injection. This as followed by continuous drip infusion of sodium thiopental in a few instances where more prolonged anesthesia was required. Children received an initial formula feeding 6 hr before their first treatment and were subsequently kept NPO (nothing by mouth) until they recovered from their second anesthesia. Recovery from thiopental was rapid and children were ready for a normal feeding within 1-1 1/2 hr of the second treatment. No parenteral feedings were required in any of these patients. Children maintained their weight during courses of radiation therapy which ranged between 19 and 43 elapsed days. There were no radiation-related treatment breaks. One child experienced two hypotensive episodes during anesthesia which responded rapidly to intravenous atropine. No other anesthetic complications occurred. This experience demonstrates that hyperfractionated radiation therapy can be safely delivered in infants requiring general anesthesia for immobilization. We feel that sodium thiopental is the anesthetic of choice in this setting because of the short duration of action and consequently rapid post-anesthesia recovery which makes it possible to achieve adequate nutrition with oral feedings alone.
4名年龄在6个月至30个月之间的儿童在全身麻醉下接受每日两次（BID）的放射治疗，治疗间隔为5 - 6小时。麻醉通过静脉推注硫喷妥钠实现。在少数需要更长时间麻醉的情况下，随后持续滴注硫喷妥钠。儿童在首次治疗前6小时接受初始配方奶喂养，随后禁食禁水（NPO），直到第二次麻醉恢复。硫喷妥钠的恢复很快，儿童在第二次治疗后1 - 1.5小时内即可正常进食。这些患者均无需胃肠外营养。儿童在19至43个治疗日的放疗过程中体重保持稳定。没有因放疗而中断治疗。一名儿童在麻醉期间出现两次低血压发作，静脉注射阿托品后迅速缓解。未发生其他麻醉并发症。该经验表明，对于需要全身麻醉以保持固定的婴儿，可以安全地进行超分割放射治疗。我们认为，在这种情况下硫喷妥钠是首选麻醉剂，因为其作用时间短，麻醉后恢复快，仅通过口服喂养就可以实现充足的营养。
