Minimising the use of sedation/anaesthesia in young children receiving radiotherapy through an effective play preparation programme.

The delivery of radiotherapy to young children is a challenging process, yet little research has been undertaken to examine practice. Many centres routinely sedate or anaesthetise young children to overcome problems relating to non-adherence to treatment. This can lead to an increased risk of clinical complications, sub-optimal nutrition, sleep disruption and is time consuming and costly. This article describes how sedation can be minimised in young children through an effective play preparation programme. To examine the effectiveness of such a programme, which had been in progress for a number of years, an audit was undertaken on a paediatric oncology unit within a regional radiotherapy centre. This took place over a 5-year period (1994-1999), on all patients aged 2-5 years. Information was collated on age, tumour type, site, duration of radiotherapy, the need for involuntary immobilisation, days requiring sedation, and whether radiotherapy was given with curative or palliative intent. Outcome data presented on 63 children suggest sedation can be minimised in this age group through the implementation of an effective play preparation programme. Of 1030 treatment days, only 111 days required sedation (10.8%), over the whole age range. No general anaesthetics were given. Only 6 patients were sedated for the whole of their treatment (9.5%), with 52 patients requiring no sedation at all (82.5%).