Anesthésies répétées en oncopédiatrie : spécificités, sécurité, impact

With the development of new procedures in cancer treatment, general anesthesia is required more and more often for children for technical and comfort reasons. Anesthesia is required for high precision procedures from diagnosis (imaging, biopsies, eye fundus) to treatment (surgery, radiotherapy, in situ chemotherapy, venous catheterism). Radiotherapy, in particular, requires daily general anesthesia for several weeks. In order to describe anesthetic exposition in pediatric oncology, we studied a retrospective cohort of 140 children of 6 years old. We extracted the anesthetic data of the children treated for a cancer, surviving after 6 years old and who we were able to follow up with. In monitoring 51 children, all have been exposed multiple times, regardless of the cancer treated. The intensity of exposure depended on the protocols of treatment associated to each cancer. The levels of exposure were high (mean of 1215 min for acute leukemia). Anesthetic exposure is the highest before three years old. This practice, when supported by adequate organization and specific protocols, can be considered safe and well tolerated. However, long-term neurotoxic effects with possible impact on cognitive and learning development are discussed. This data recommends measured decisions and continued vigilance for a vulnerable population who are repeatedly exposed.