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VLADI An alternative
to anesthesia in
radiotherapy
treatments
Ana Roma Calccedilaratildeo
Project initiated by Caacutetia Aacuteguas amp Philippe Humblet
2018-04-23
Video Launching Applied During Irradiation (VLADI)
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
2
Disclosure amp Disclaimer
ldquoThe views expressed in this presentation are those of the presenters and do not necessarily reflect the views or policies of Accuray Incorporated or its subsidiaries No
official endorsement by Accuray Incorporated or any of its subsidiaries of any vendor products or services contained
in this presentation is intended or should be inferredrdquo
An honorarium is provided by Accuray for this presentation
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
3
Radiotherapy Treatment
Impressive and noisy environment
Presence of unknown objects Feeling of isolation
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
4
Radiotherapy Treatment
Patient comfortPrecision
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
5
Radiotherapy Treatment
PatientHypnosis
Parents speaking
Music
General Anesthesia
How to ensure the patient compliance Solutions
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Simulation
6
General Anesthesia
Evaluation of the safety and efficacy of repeated sedations for the
radiotherapy of young children with cancer a prospective study of
1033 consecutive sedationsSeiler G1 De Vol E Khafaga Y Gregory B Al-Shabanah M Valmores A VersteegD Ellis B Mustafa MM Gray AInt J Radiat Oncol Biol Phys 2001 Mar 149(3)771-83
Anesthesia for pediatric external beam radiation therapy
Fortney JT1 Halperin EC Hertz CM Schulman SR
Int J Radiat Oncol Biol Phys 1999 Jun 144(3)587-91
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
2
Disclosure amp Disclaimer
ldquoThe views expressed in this presentation are those of the presenters and do not necessarily reflect the views or policies of Accuray Incorporated or its subsidiaries No
official endorsement by Accuray Incorporated or any of its subsidiaries of any vendor products or services contained
in this presentation is intended or should be inferredrdquo
An honorarium is provided by Accuray for this presentation
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
3
Radiotherapy Treatment
Impressive and noisy environment
Presence of unknown objects Feeling of isolation
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
4
Radiotherapy Treatment
Patient comfortPrecision
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
5
Radiotherapy Treatment
PatientHypnosis
Parents speaking
Music
General Anesthesia
How to ensure the patient compliance Solutions
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Simulation
6
General Anesthesia
Evaluation of the safety and efficacy of repeated sedations for the
radiotherapy of young children with cancer a prospective study of
1033 consecutive sedationsSeiler G1 De Vol E Khafaga Y Gregory B Al-Shabanah M Valmores A VersteegD Ellis B Mustafa MM Gray AInt J Radiat Oncol Biol Phys 2001 Mar 149(3)771-83
Anesthesia for pediatric external beam radiation therapy
Fortney JT1 Halperin EC Hertz CM Schulman SR
Int J Radiat Oncol Biol Phys 1999 Jun 144(3)587-91
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
3
Radiotherapy Treatment
Impressive and noisy environment
Presence of unknown objects Feeling of isolation
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
4
Radiotherapy Treatment
Patient comfortPrecision
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
5
Radiotherapy Treatment
PatientHypnosis
Parents speaking
Music
General Anesthesia
How to ensure the patient compliance Solutions
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Simulation
6
General Anesthesia
Evaluation of the safety and efficacy of repeated sedations for the
radiotherapy of young children with cancer a prospective study of
1033 consecutive sedationsSeiler G1 De Vol E Khafaga Y Gregory B Al-Shabanah M Valmores A VersteegD Ellis B Mustafa MM Gray AInt J Radiat Oncol Biol Phys 2001 Mar 149(3)771-83
Anesthesia for pediatric external beam radiation therapy
Fortney JT1 Halperin EC Hertz CM Schulman SR
Int J Radiat Oncol Biol Phys 1999 Jun 144(3)587-91
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
4
Radiotherapy Treatment
Patient comfortPrecision
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
5
Radiotherapy Treatment
PatientHypnosis
Parents speaking
Music
General Anesthesia
How to ensure the patient compliance Solutions
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Simulation
6
General Anesthesia
Evaluation of the safety and efficacy of repeated sedations for the
radiotherapy of young children with cancer a prospective study of
1033 consecutive sedationsSeiler G1 De Vol E Khafaga Y Gregory B Al-Shabanah M Valmores A VersteegD Ellis B Mustafa MM Gray AInt J Radiat Oncol Biol Phys 2001 Mar 149(3)771-83
Anesthesia for pediatric external beam radiation therapy
Fortney JT1 Halperin EC Hertz CM Schulman SR
Int J Radiat Oncol Biol Phys 1999 Jun 144(3)587-91
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
5
Radiotherapy Treatment
PatientHypnosis
Parents speaking
Music
General Anesthesia
How to ensure the patient compliance Solutions
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Simulation
6
General Anesthesia
Evaluation of the safety and efficacy of repeated sedations for the
radiotherapy of young children with cancer a prospective study of
1033 consecutive sedationsSeiler G1 De Vol E Khafaga Y Gregory B Al-Shabanah M Valmores A VersteegD Ellis B Mustafa MM Gray AInt J Radiat Oncol Biol Phys 2001 Mar 149(3)771-83
Anesthesia for pediatric external beam radiation therapy
Fortney JT1 Halperin EC Hertz CM Schulman SR
Int J Radiat Oncol Biol Phys 1999 Jun 144(3)587-91
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Simulation
6
General Anesthesia
Evaluation of the safety and efficacy of repeated sedations for the
radiotherapy of young children with cancer a prospective study of
1033 consecutive sedationsSeiler G1 De Vol E Khafaga Y Gregory B Al-Shabanah M Valmores A VersteegD Ellis B Mustafa MM Gray AInt J Radiat Oncol Biol Phys 2001 Mar 149(3)771-83
Anesthesia for pediatric external beam radiation therapy
Fortney JT1 Halperin EC Hertz CM Schulman SR
Int J Radiat Oncol Biol Phys 1999 Jun 144(3)587-91
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
7
General Anesthesia
Constraints related to GA
bull Prolonged patient setup
bull Painfulunpleasant procedure
bull Need to maintain patient airway
bull Need for post-anesthesia recovery period
bull Impact on patientrsquos daily life ( eating drinking and playing)
Int J Radiation Oncology Biol Phys Vol 44 No3 pp587-591 1999 ndash Anesthesia for pediatric external Beam Radiation Therapy
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
8
General Anesthesia
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
9
Impact of General Anesthesia
Child Family
The radiotherapy department
The Anesthesia department
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
10
Radiotherapy Treatment
PatientcomplianceHypnose
Parents speaking
Music
General Anesthesia
VLADI
Our Solution
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
11
VLADI An alternative to anesthesia in radiotherapy treatments
Video Lauching Applied DuringIrradiation
VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
12
Project VLADI
video
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
13
VLADI - Purpose and Objective
Replace the use of GA
Reassure and distract
Impact on Treatment and
Workflow
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
14
VLADI - Purpose and Objective
Project started in 2014
Evaluate the impact of this project on the potential reduction of the use of GA for children between the ages of
2 and 6 years old
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
15
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Group 1 (n=6) pediatric patients before VLADI
Group 2 (n=6) pediatric patients after VLADI
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
16
VLADI vs General Anesthesia
000
1000
2000
3000
4000
5000
6000
7000
8000
9000
Anesthesia No Anesthesia
Before VLADI
After VLADI
Decrease of general anesthesia
833 GA (before VLADI)
333 GA (after VLADI)
VLADI benefits 667 of pediatric patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
17
VLADI The Benefits
- Increased patientfamily satisfaction Treatment is like going to the movie
theatre
- Increased efficiency Less time consuming
- Decreased financial impact
- Decrease in pre-treatment medication use
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
18
Conclusions
bull The use of VLADI as an alternative to anesthesia represents a gain both at the
level of patient care (less medication) but also on a workflow level
bull In our department VLADI has almost completely replaced anesthesia
resulting in reduced treatment times and reduction of stress for young
patients their family and the RTT team
bull Future prospect extension to claustrophobic patients
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
Cliniques universitaires Saint-Luc ndash Radiotherapy Department
Questions
19
