Can pediatric Gamma Knife radiosurgery be managed under monitored anesthesia care? A case presentation and proposal from anesthesiologists†

Gamma Knife radiosurgery is generally performed under procedural sedation and analgesia. However, there are some risks regarding the patient's respiratory function and the specifics of its management, since the presence of a stereotactic frame may impede access to the patient's airway and interfere with direct visual observation by medical personnel. Monitored anesthesia care, which is a specific anesthesia service for diagnostic or therapeutic procedures that involve various levels of sedation, analgesia and anxiolysis, is recognized as producing less physiologic disturbance while allowing a more rapid recovery than general anesthesia. The selection of suitable candidates and medications, as well as the early detection of respiratory deterioration are considered to be essential for patient safety.