1/2. hypnosis instead of general anaesthesia in paediatric radiotherapy: report of three cases.PURPOSE: This report proposes hypnosis as a valid alternative to general anaesthesia for immobilisation and set-up in certain cases in paediatric radiotherapy. methods: We report three cases of children who underwent radiotherapy in 1994 and were treated using hypnosis for set-up during irradiation. The first and the second were two cases of macroscopic resection of cerebellar medulloblastoma in which craniospinal irradiation was necessary, while the third patient suffered of an endorbitary relapse of retinoblastoma previously treated with bilateral enucleation, radiotherapy and chemotherapy; in this last situation the child needed radiation as palliative therapy. hypnosis was used during treatment to obtain the indispensable immobility. Hypnotic conditioning was obtained by our expert psychotherapist while the induction during every single treatment was made by the clinician, whose voice was presented to the children during the conditioning. RESULTS: Every single fraction of the radiation therapy was delivered in hypnosis and without the need for narcosis. CONCLUSIONS: hypnosis may be useful in particular situations to prepare paediatric cancer patients during irradiation, when lack of child collaboration might necessitate the use of general anaesthesia and when anaesthesia itself is not possible.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Repeat ketamine anaesthesia of a child for radiotherapy in the prone position.Sixteen ketamine anaesthetics over an eight-week period for a course of postoperative radiotherapy following removal of a medulloblastoma in an 18-month-old child are described. On each occasion the child was in the prone position with a tight fitting shell covering the head, trunk and arms. The problems of repeated anaesthetics, isolation of the child in one room from the anaesthetist in another, and psychological upset to the mother and child are discussed. ketamine was chosen because with this agent the patient usually maintains a clear airway, even in unusual postures. It was used successfully by both the intramuscular and rectal routes, thus avoiding repeated venepuncture and intubation. Post-anaesthetic nausea was a problem, but tolerance to ketamine and psychological emergence phenomena did not occur.- - - - - - - - - - ranking = 0.57142857142857keywords = anaesthesia (Clic here for more details about this article) |