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2008 | 3 | 1 | 77-82
Tytuł artykułu

Safety and efficacy of two protocols for sedation in pediatric oncology procedures

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Invasive procedures, such as the lumbar puncture, can cause anxiety and pain in children undergoing treatment for acute lymphoblastic leukemia (ALL). We investigated the safety and efficacy of two different protocols for pain relief in 20 children with ALL undergoing lumbar puncture. Protocol A was composed of an association between propofol and alfentanil. Protocol B consisted in the combination of propofol and ketamine. Vital and behavioural parameters, sedation and pain scores were recorded at different times during and after the procedure. All patients showed a satisfactory sedation and analgesia. We found a statistically significant difference of vital parameters between protocol A and protocol B, while there were no significative differences between sedation scores and the other parameters evaluated. Patients in protocol A showed a higher incidence of major side effects, such as respiratory depression. Our results show that both protocols are effective to obtain a good sedation and analgesia in children with ALL undergoing lumbar puncture, but the association between propofol and ketamine appears more safe due to the lower incidence of side effects.
Słowa kluczowe
Wydawca
Czasopismo
Rocznik
Tom
3
Numer
1
Strony
77-82
Opis fizyczny
Daty
wydano
2008-03-01
online
2008-03-01
Twórcy
  • Department of Pediatric Oncology, Catholic University Medical School, Rome, Italy
  • Pediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy
  • Pediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy
autor
  • Pediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy
  • Pediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy
Bibliografia
  • [1] Alexander J., Manno M., Underuse of analgesia in very young patients with isolated painful injures, Ann Emerg Med, 2003, 4, 617–622 http://dx.doi.org/10.1067/mem.2003.138[Crossref]
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  • [4] Keidan I., Berkenstadt H., Sidi A., Perel A. Propofol/remifentanil versus propofol alone for bone marrow aspiration in paediatric haemato-oncological patients, Paediatr Anaesth, 2001, 11, 297–301 http://dx.doi.org/10.1046/j.1460-9592.2001.00662.x[Crossref]
  • [5] Krauss B., Green S.M., Sedation and analgesia for procedures in children, N Eng J Med, 2000, 342, 938–945 http://dx.doi.org/10.1056/NEJM200003303421306[Crossref]
  • [6] Litman R.S., Conscious sedation with remifentanil and midazolam during brief painful procedures in children, J Pain Simptom Manage, 2000, 19, 468–471 http://dx.doi.org/10.1016/S0885-3924(00)00141-X[Crossref]
  • [7] Foubert L., Reyntjens K., Wolf D., Suys B., Moerman A., Mortier E., Remifentanil infusion for cardiac catheterization in children with congenital heart disease, Acta Anaesthesiol Scand, 2002, 46, 355–360 http://dx.doi.org/10.1034/j.1399-6576.2002.460404.x[Crossref]
  • [8] Hostetler M.A., Auinger P., Szilagyi P.G., Parenteral analgesic and sedative use among ED patients in the United States: combined results from the National Hospitalal Ambulatory Medical Care Survey (NHAMCS) 1992–1997, Am J Emerg Med, 2002, 20, 139–143 http://dx.doi.org/10.1053/ajem.2002.33002[Crossref]
  • [9] Green S.M., Krauss B., Profol in emergency medicine: pushing the sedation frontier, Ann Emerg Med,2003, 42, 773–782 http://dx.doi.org/10.1016/S0196-0644(03)00619-X[Crossref]
  • [10] Wehrmann T., Kokabpick S., Lembcke B., Caspary W.F., Seifert H., Efficacy and safety of intravenous propofol sedation during routine ERCP: a prospective, controlled study, Gastrointest Endosc, 1999, 49, 677–683 http://dx.doi.org/10.1016/S0016-5107(99)70281-6[Crossref]
  • [11] Antmen B., Sasmaz I., Birbicer H., Ozbek H., Burguts R., Isik G., et al, Safe and effective sedation and analgesia for bone marrow aspiration procedures in children with alfentanil, remifentanil and combination with midazolam, Pediatric Anesthesia, 2005, 15, 214–219 http://dx.doi.org/10.1111/j.1460-9592.2004.01411.x[Crossref]
  • [12] Bailey P.L., Stanley T.H., Intravenous opioid anesthetics, in: Stoelting RK, Miller RD (ed): Basics of anesthesia, 4rd ed., New York N, Churchill Livingstone, 1994
  • [13] Kim G., Green S.M., Denmark T.K., Krauss B., Ventilatory response during dissociative sedation in children: a pilot study, Acad Emerg Med, 2003, 10, 140–145
  • [14] Munro A., Machonochie I., Midazolam or ketamine for procedural sedation of children in the emeregency department, Emerg Med J, 2007, 24, 579–580 http://dx.doi.org/10.1136/emj.2007.051318[Crossref][WoS]
  • [15] Walker R, ASA and Cepod scoring, Update in anaesthesia, 2002, 14, 1
  • [16] Crellin D., Sullivan T., Babe F., Analysis of the validation of existing behavioral pain and distress scales for use in the procedural setting Pediatr Anesthesia, 2007, 17, 720–733 http://dx.doi.org/10.1111/j.1460-9592.2007.02218.x[Crossref]
  • [17] Carrer S., Bocchi A., Candini M., Donegà L., Tartari S., Short term analgesia based sedation in the Intensive Care Unit: morphine vs remifentanil and morphine, Minerva Anestesiol Vol, 2007, 73, 327–332
  • [18] Kaabachi O., Chettaoui O., Ouezini R., Abdelaziz AB, Cherif R, Kokki H, A ketamine-propofol admixture does not reduce the pain on injection compared with a lidocaine-propofol admixture, Pediatr Anaesthes, 2007, 17, 734–737 http://dx.doi.org/10.1111/j.1460-9592.2007.02242.x[Crossref]
  • [19] Guit J.B., Koning H.M., Coster M.L., Niemeijer R.P., Mackie D.P., Ketamine as analgesic for total intravenous anaesthesia with propofol, Anaesthesia, 1991, 46, 24–27 http://dx.doi.org/10.1111/j.1365-2044.1991.tb09308.x[Crossref]
  • [20] Golden S., Combination propofol-ketamine anaesthesia in sick neonates, Paed Anaesth, 2001, 11, 119–122 http://dx.doi.org/10.1046/j.1460-9592.2001.00605.x[Crossref]
  • [21] Ostreikov I.F.,. Milenin V.V, Vasil’ev IaI, Mishustin V.V., Cherdantsev S.V., Central hemodynamics conditions of combined intravenous anesthesia using propofol and ketamine in pediatric ophthalmology, Anesteziol Reanimatol, 2002, 11, 22–24
  • [22] Newman D.H., Azer M.M., Pitetti R.D., Singh S., When is a patient safe for discharge after procedural sedation? The timing of adverse effect events in 1367 pediatric procedural sedations, Ann Emerg Med, 2003, 42, 627–635 http://dx.doi.org/10.1016/S0196-0644(03)00446-3[Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-008-0001-6
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