Máscaras pediátricas de imobilização: personalização, adesão à radioterapia e redução do uso de anestesia no Instituto Nacional de Câncer – INCA- RJ

Abstract

Summary Introduction: Children with CNS tumors need adequate immobilization for accurate irradiation. However, many of them, due to age or insecurity, require sedation for adequate immobilization. Objective: To evaluate the influence of the use of individualized immobilization thermoplastic masks decorated and customized for pediatric irradiation dynamics in our department. Methods: A retrospective and observational evaluation was carried out, with quantitative results of the number of pediatric patients using decorated and non-decorated thermoplastic masks, that required or not sedation between 2015 and 2016. The financial cost of the material involved in the daily sedation of an irradiated patient was compared to the cost without sedation. Data were obtained from manangement intructions from radiotherapy and anesthesia departments .Results: From January 2015 to December 2016, 62 children were treated. Thirty-eight used sedation (61%). Before using personalized masks, 75.6% of the cases required anesthesia, and, after its use, 33.3% (adecrease of 44%). Three children contributed to the adherence to the treatment of other children, making the painful process in something playful. The financial specific materail costs (sedative plus the masks) of a treatment involving daily sedation in a total of 25 days was R $ 2.660,00 and, without sedation, R $ 151.00. The mean daily time spent with and without sedation was 35 min versus 12 min, respectively. Conclusions: Personalized decorated masks of irradiated children contributed significantly to the adhesion and reduction of the time of radiotherapy procedures, allowing an increase in the number of patients treated, reducing anesthesia need, and reducing expenditure with sedation drugs. This approach contributes to the prevention of side effects of daily sedation, optimization of treatment time in radiation devices, costs reduction with sedation and hospital supplies and provides humanization care. It was shown radiotherapy flow improvement, inherent material costs reduction and optimization of radiotherapy treatment time. We suggest to other services to adopt sistematically this procedure in children's treatments.