Anesthesia and pain management for cervical cancer brachytherapy in high and low resource settings-Anesthesia and pain management for cervical cancer brachytherapy in high and low resource settings

Anesthesia and pain management for cervical cancer brachytherapy in high and low resource settings

Video Transcription

Video Summary

The webinar, hosted by the International Gynecologic Cancer Society and American Brachytherapy Society, focused on anesthesia and pain management for cervical cancer brachytherapy in high- and low-resource settings. Moderators introduced key sedation and anesthesia terms, then reviewed audience poll results showing wide variation in case volume, anesthesia access, procedure location, and provider type. A central message was that brachytherapy is essential for cure, but pain control strategies depend heavily on resources, workflow, and team coordination.<br /><br />Panelists from India, South Africa, Bolivia, and Canada described very different but effective approaches. India reported frequent use of general anesthesia in high-volume practice, with spinal anesthesia offering better early pain control but general anesthesia often preferred for workflow efficiency. South Africa highlighted major shortages of anesthesiologists, infrastructure, and nursing support, leading to heavy reliance on conscious sedation. Bolivia emphasized how reimbursement, access, and ambulatory workflow shape care, and described an ultra-short-acting TIVA protocol using remifentanil, propofol, and ketamine. Canada presented MRI-guided outpatient brachytherapy under general anesthesia to reduce overnight pain and trauma.<br /><br />Discussion addressed paracervical blocks, applicator removal pain, hypertension before anesthesia, overnight analgesia, MRI versus CT guidance, and remifentanil use. Overall, the session stressed adapting evidence-based pain management to local realities.

Keywords

cervical cancer brachytherapy

anesthesia

pain management

sedation

general anesthesia

spinal anesthesia

conscious sedation

remifentanil

resource-limited settings