title: A multi-institutional pilot survey of anesthesia practices during proton radiation therapy.
abstract: OBJECTIVE
  Physicians responsible for anesthesia and/or sedation (A/S) at emerging proton radiation therapy centers (PTCs) seek information about practices at established centers. We conducted a survey of A/S practices at established PTCs to provide this information for physicians at new PTCs.
  
  
  METHODS
  A web-based survey was sent to physicians responsible for A/S at 37 established PTCs. Questions were based on practice patterns and the preferred method of A/S delivery during proton-radiation therapy. One representative per institution was surveyed.
  
  
  RESULTS
  A response rate of 38%, with a combined case load of more than 15,000 anesthetics per year was obtained. Children younger than 4 years old often (72%) required A/S. The most favored A/S techniques involved total intravenous anesthesia with propofol and an unprotected airway (57%) or general anesthesia with sevoflurane and a laryngeal mask airway (36%). It was notable that 21% of facilities did not have dedicated recovery rooms. Also, anesthesia gas evacuation outlets were absent at 43% of treatment rooms.
  
  
  CONCLUSIONS
  A/S is commonly delivered to patients undergoing proton radiation therapy, most often with total intravenous anesthesia. To avert potential obstacles to the safe delivery of care, anesthesiologists at emerging centers are encouraged to participate throughout the design and planning phases of new PTCs.
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: poagyemang@mdanderson.org.
authors.forename: Pascal
authors.initials: P
authors.lastname: Owusu-Agyemang
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Popovich
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Acsa M
authors.initials: AM
authors.lastname: Zavala
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: David R
authors.initials: DR
authors.lastname: Grosshans
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Van Meter
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Uduak U
authors.initials: UU
authors.lastname: Williams
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Allen A
authors.initials: AA
authors.lastname: Holmes
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Radha
authors.initials: R
authors.lastname: Arunkumar
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rebello
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: McAleer
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Vivian
authors.initials: V
authors.lastname: Porche
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
mesh_terms: D000758:Anesthesia / Q000379:methods*; D005260:Female; D006801:Humans; D010865:Pilot Projects; D061766:Proton Therapy / Q000379:methods*; D011874:Radiometry / Q000379:methods*; D011795:Surveys and Questionnaires