Non-anesthetist-administered moderate sedation with midazolam and fentanyl for outpatient MRI-aided hybrid intracavitary and interstitial brachytherapy in cervix cancer: a single-institution experience.
Non-anesthetist-administered moderate sedation with midazolam and fentanyl for outpatient MRI-aided hybrid intracavitary and interstitial brachytherapy in cervix cancer: a single-institution experience.
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DOI：
10.5114/jcb.2021.105946
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发表时间：
2021-06
影响因子：
1.4
通讯作者：
Tan TK
中科院分区：
文献类型：
--
作者：
Sommat K;Lin JYX;Chew MML;Loh CS;Liew JSK;Foo YW;Kwek JW;Hennedige T;Goh JPS;Tan TK
本研究的目的是确定在非麻醉师给予的中度镇静下间质近距离放疗的可行性，确定影响插入的因素和总手术时间。2017年3月至2020年3月，共对23例患者进行了47次腔内和腔间混合应用器插入。非麻醉师静脉注射咪达唑仑和芬太尼达到中度镇静。记录插入时间和手术时间。通过单因素和多因素分析评估不同因素对插入和手术时间的影响。共植入238根针（范围2-8根），平均插入深度30 mm（范围20-40 mm）。咪达唑仑和芬太尼的平均剂量分别为每次插入3mg（标准差[SD] = 1）和53.3 mcg （SD = 23.9）。中位插入时间为30分钟（四分位数间距[IQR] = 22-40），中位总手术时间为4.3小时（IQR = 3.6-5.2）。首次插入、2019年之前进行的插入和较高的咪达唑仑剂量与较长的插入时间相关，而较长的插入时间、基于mri的计划和2019年之前进行的插入与较长的总手术时间相关。门诊间质性近距离治疗与非麻醉给药镇静是可以实现的和良好的耐受性。这种方法可以显著减轻医院资源负担，具有成本效益的潜力。
The aim of the study was to determine the feasibility of interstitial brachytherapy under non-anesthetist-administered moderate sedation, to identify factors influencing the insertion, and the total procedural time. A total of 47 insertions with hybrid intracavitary and interstitial applicators were performed in 23 patients from March 2017 to March 2020. Moderate sedation was achieved with intravenous midazolam and fentanyl administered by non-anesthetist. Insertion time and procedural time was recorded. Univariate and multivariate analysis were performed to evaluate the impact of different factors on insertion and procedural time. A total of 238 needles (range, 2-8 per insertion) were implanted, with an average insertion depth of 30 mm (range, 20-40 mm). The mean doses for midazolam and fentanyl were 3 mg (standard deviation [SD] = 1) and 53.3 mcg (SD = 23.9) per insertion, respectively. The median insertion time was 30 minutes (interquartile range [IQR] = 22-40), and the median total procedural time was 4.3 hours (IQR = 3.6-5.2). First time insertion, insertions performed before 2019, and higher midazolam dose were associated with significantly longer insertion time, whereas longer insertion time, MRI-based planning, and insertions performed before 2019 were associated with significantly longer total procedural time. Outpatient interstitial brachytherapy with non-anesthetist-administered sedation is achievable and well-tolerated. This method may significantly lessen the burden on hospital resources and has the potential to be cost-effective.
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影响因子：
2.6
作者：
Bhanabhai, H.;Samant, R.;Lowry, S.
通讯作者：
Lowry, S.
影响因子：
7.7
作者：
Mamula, Petar;Markowitz, Jonathan E.;Liacouras, Chris A.
通讯作者：
Liacouras, Chris A.
影响因子：
2
作者：
Ohno T;Wakatsuki M;Toita T;Kaneyasu Y;Yoshida K;Kato S;Ii N;Tokumaru S;Ikushima H;Uno T;Noda SE;Kazumoto T;Harima Y;The Working Group of the Gynecological Tumor Committee of the Japanese Radiation Oncology Study Group (JROSG)
通讯作者：
The Working Group of the Gynecological Tumor Committee of the Japanese Radiation Oncology Study Group (JROSG)
DOI：
10.1097/igc.0000000000000929
发表时间：
2017-05
期刊：
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
影响因子：
--
作者：
Liu ZS;Guo J;Zhao YZ;Lin X;Zhang BY;Zhang C;Wang HY;Yu L;Ren XJ;Wang TJ
通讯作者：
Wang TJ
影响因子：
1.9
作者：
Khader, Ruba;Oreadi, Daniel;Rosenberg, Morton
通讯作者：
Rosenberg, Morton