title: Caudal epidural anesthesia during intracavitary brachytherapy for cervical cancer.
abstract: It has been suggested that pain control during intracavitary brachytherapy for cervical cancer is insufficient in most hospitals in Japan. Our hospital began using caudal epidural anesthesia during high-dose-rate (HDR) intracavitary brachytherapy in 2011. The purpose of the present study was to retrospectively investigate the effects of caudal epidural anesthesia during HDR intracavitary brachytherapy for cervical cancer patients. Caudal epidural anesthesia for 34 cervical cancer patients was performed during HDR intracavitary brachytherapy between October 2011 and August 2013. We used the patients' self-reported Numeric Rating Scale (NRS) score at the first session of HDR intracavitary brachytherapy as a subjective evaluation of pain. We compared NRS scores of the patients with anesthesia with those of 30 patients who underwent HDR intracavitary brachytherapy without sacral epidural anesthesia at our hospital between May 2010 and August 2011. Caudal epidural anesthesia succeeded in 33 patients (97%), and the NRS score was recorded in 30 patients. The mean NRS score of the anesthesia group was 5.17 ± 2.97, significantly lower than that of the control group's 6.80 ± 2.59 (P = 0.035). The caudal epidural block resulted in no side-effects. Caudal epidural anesthesia is an effective and safe anesthesia option during HDR intracavitary brachytherapy for cervical cancer.
authors: Department of Radiation Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan shirakawa.y@nk-cc.go.jp.
authors: Yuko
authors: Y
authors: Isoyama-Shirakawa
authors: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors: Katsumasa
authors: K
authors: Nakamura
authors: Department of Radiation Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
authors: Madoka
authors: M
authors: Abe
authors: Department of Radiation Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
authors: Naonobu
authors: N
authors: Kunitake
authors: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors: Keiji
authors: K
authors: Matsumoto
authors: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors: Saiji
authors: S
authors: Ohga
authors: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors: Tomonari
authors: T
authors: Sasaki
authors: Department of Radiation Oncology, Fukuoka Tokushukai Hospital, 4-5 Sukukita, Kasuga, Fukuoka 816-0864, Japan.
authors: Satoru
authors: S
authors: Uehara
authors: Department of Radiation Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
authors: Kazuhiro
authors: K
authors: Okushima
authors: Ion Beam Therapy Center, SAGA-HIMAT Foundation, 415 Harakoga, Tosu, Saga 841-0071, Japan.
authors: Yoshiyuki
authors: Y
authors: Shioyama
authors: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors: Hiroshi
authors: H
authors: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000763:Anesthesia, Caudal / Q000379:methods*; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
keywords: caudal epidural anesthesia; cervical cancer; intracavitary brachytherapy; pain control