{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T15:32:16Z","timestamp":1778599936451,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Proton beam therapy is an oncological treatment, argued to be an appropriate tumor irradiation technique for childhood solid tumors. Due to its duration and the need for immobility, many children require anesthesia for proton therapy sessions. As not many centers in the world provide this therapy, there is little published research about pediatric anesthesia for these cases, and the available data suggest a preference for intravenous anesthesia or combined intravenous and inhalation anesthesia. We conducted this study with the aim of describing and analyzing the inhalation anesthetic management of children undergoing proton therapy at our medical center, comparing our results with studies that have followed different anesthetic protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed two major databases (Web of Science and Scopus) to find papers that had addressed, to date, anesthesia for pediatric proton therapy. To describe our anesthetic management, we included all pediatric patients treated with proton therapy under anesthesia in our center between June 2020 and August 2021. The characteristics of the patients, their diagnoses, treatments, airway management, drugs administered, duration of induction, and recovery from anesthesia, and adverse effects where all recorded. All anesthesiologists followed a strict anesthetic protocol based only on inhalational anesthesia with sevoflurane delivered via laryngeal mask airway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the total of 1082 papers found in Web of Science and Scopus on pediatric proton therapy, 11 have addressed its anesthetic management, using intravenous or combined intravenous and inhalation anesthesia. Between June 2020 and August 2021, 31 children were anesthetized in our center to receive proton therapy under inhalational anesthesia (total number of sessions: 873). The mean anesthesia induction time was 4.1\u2009min (SD\u2009=\u20090.7, 95% CI [3.9, 4.4]). The mean anesthesia recovery time was 13.8\u2009min (SD\u2009=\u20094.1, 95% CI [12.3, 15.3]). The percentage of non\u2010serious adverse effects was 0.7% (Clopper\u2013Pearson 95% CI [0.3, 1.5]). The percentage of serious adverse effects was 0.1% (Clopper\u2013Pearson 95% CI [0, 0.6]), without statistically significant difference with other published works with different anesthetic approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Inhalation anesthesia without any intravenous management for pediatric proton therapy is, in our experience, an effective technique with a complication rate similar to other anesthetic approaches.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14739","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T11:25:25Z","timestamp":1690889125000},"page":"946-954","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Inhalation anesthesia without any intravenous management for pediatric proton beam therapy"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8052-9865","authenticated-orcid":false,"given":"Miguel A.","family":"Garc\u00eda\u2010Aroca","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 M.","family":"Fern\u00e1ndez\u2010de\u00a0Miguel","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Aymerich\u2010de","family":"Franceschi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Fern\u00e1ndez\u2010Vaquero","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego A.","family":"Mel\u00e9ndez\u2010Salinas","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Pi\u00f1ero\u2010Merino","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 M.","family":"\u00c1lvarez\u2010Avello","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Cl\u00ednica Universidad de Navarra  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-7-170"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.10.025"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3181b6127c"},{"issue":"1","key":"e_1_2_9_5_1","first-page":"1","article-title":"Proton beam therapy for cancer in children and adults: a health technology assessment","volume":"21","author":"Ont health (quality)","year":"2021","journal-title":"Ont Health Technol Assess Ser"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2016.06.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2013.09.002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ANCLIN.2020.06.003"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.10.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.01.016"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aem207"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02273.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-012-2085-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-016-2090-4"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-72223-z"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2015.10.020"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-43545-9_19"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1043454218767885"},{"issue":"4","key":"e_1_2_9_20_1","first-page":"461","article-title":"Preoperative evaluation in infants and children: recommendations of the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI)","volume":"80","author":"Serafini G","year":"2014","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001452"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32833b1adf"},{"key":"e_1_2_9_23_1","unstructured":"Committee on Standards and Practice Parameters (CSPP).https:\/\/www.asahq.org\/standards\u2010and\u2010guidelines\/standards\u2010for\u2010basic\u2010anesthetic\u2010monitoring. Published 2020.https:\/\/www.asahq.org\/standards\u2010and\u2010guidelines\/standards\u2010for\u2010basic\u2010anesthetic\u2010monitoring#\/"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.02962.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199404000-00014"},{"key":"e_1_2_9_26_1","unstructured":"Royal College of Radiologists Society and College of Radiographers Institute of Physics and Engineering in Medicine Children's Cancer and Leukaemia Group.https:\/\/www.rcr.ac.uk\/publication\/good\u2010practice\u2010guide\u2010paediatric\u2010radiotherapy\u2010second\u2010edition. Royal College of Radiologists. Published 2018.www.rcr.ac.uk"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-020-04286-x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1591"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13567"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14613"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/7289310"},{"key":"e_1_2_9_32_1","unstructured":"NHS Education for Scotland.https:\/\/www.sdcep.org.uk\/media\/iegenn4c\/sdcep\u2010conscious\u2010sedation\u2010guidance.pdf"},{"issue":"4","key":"e_1_2_9_33_1","first-page":"259","article-title":"Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures","volume":"41","author":"Cot\u00e9 CJ","year":"2019","journal-title":"Pediatr Dent"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2014.08.002"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1460408618798391"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3282f8ad76"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2020.107163"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000642"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13760"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001037"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.11.001"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000316"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-019-01385-w"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-020-01726-0"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(17)30040-2"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1301"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.03.004"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15598"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/S40272-017-0259-8"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000075"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14739","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T08:28:57Z","timestamp":1696408137000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":49,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/pan.14739"],"URL":"https:\/\/doi.org\/10.1111\/pan.14739","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"2023-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}