Deep sedation for endoluminal brachytherapy of the cervix

Abstract

Objectives: Cervical cancer is a gynecologic oncologic pathology of great impact on women worldwide, and brachytherapy is one of the main therapeutic methods used in its treatment. The aim of this study was to describe the sedation and analgesia techniques used during endoluminal cervical brachytherapy at the Hospital Universitario San Ignacio (HUSI). Materials and Methods: A cross-sectional study was conducted, in which the electronic medical records of patients undergoing cervical, endometrial or vaginal brachytherapy, registered in the HUSI database, between January 1, 2015 and December 31, 2020, were reviewed. Data collection was carried out using the Redcap program, under the supervision of the protocol investigators. Results: In this study it was observed that all procedures were performed under sedation, using a technique of anxiolytics, opiates, and hypnotics. Our work provides significant value by demonstrating that the procedure could be performed safely, effectively, and reliably, with sedation administered by anesthesiologists. Conclusions: Although brachytherapy is a promising option for the treatment of cervical cancer, it is a painful procedure and generates discomfort. Since there are no internationally standardized protocols for sedation methods, it is likely that patients are not receiving the most appropriate technique, which causes suffering and fear of brachytherapy. For this reason, the results obtained in this study provide valuable evidence in the Latino population to encourage the implementation of models of care in hospitals that perform this procedure.