title: A study of complications arising from different methods of anesthesia used in high-dose-rate brachytherapy for cervical cancer.
abstract: The purpose of this report is to review the complications related to different methods of anesthesia for high-dose-rate (HDR) brachytherapy for cervical carcinoma. All patients diagnosed with cervical cancer between 1999 and 2002 treated with 3-channel HDR brachytherapy were entered. Complications due to anesthesia for each fraction of brachytherapy were graded using the Common Toxicity Criteria. Eighty-four fractions of brachytherapy were delivered to 18 patients: 19 fractions with patients under general anesthesia (GA), 41 with patients under topical anesthesia and sedation, 5 with patients under paracervical nerve block, and 19 with patients under conscious sedation. Thirteen complications were reported: 12 related to GA and 1 due to paracervical nerve block. Of complications due to GA, 7 were grade 1 and 5 were grade 2. The complication due to paracervical nerve block (seizure) was grade 3. GA had significantly more complications than topical anesthesia or conscious sedation (both P < 0.001). HDR brachytherapy for cervical cancer under GA has significantly more complications than other methods. Given the increasing use of fractionated 3-channel brachytherapy, further investigation of risks and benefits of anesthetic techniques is required.
authors.affiliation: Department of Radiation Oncology, The Cancer Institute, National University Hospital, Singapore. keith_LIM@mail.nhg.com.sg
authors.forename: Keith H C
authors.initials: KH
authors.lastname: Lim
authors.forename: Jiade J
authors.initials: JJ
authors.lastname: Lu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Wynne
authors.forename: Michael F
authors.initials: MF
authors.lastname: Back
authors.forename: Rahul
authors.initials: R
authors.lastname: Mukherjee
authors.forename: Khalil
authors.initials: K
authors.lastname: Razvi
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Shakespeare
mesh_terms: D000758:Anesthesia / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects; D000772:Anesthesia, Local / Q000009:adverse effects; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D016292:Procedural Sedation / Q000009:adverse effects; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*