Pediatric oncology sedation trial (POST): A double‐blind randomized study

Nagel, Kim; Willan, Andrew R.; Lappan, Janie; Korz, Linda; Buckley, Norman; Barr, Ronald D.

doi:10.1002/pbc.21669

Cited by 19 publications

(13 citation statements)

References 15 publications

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“…However, this procedure causes a great deal of pain and suffering for the patients and their relatives. Furthermore, it often fails or causes injury, with delays in treatment of cerebral leukemia or multiple attempts in one procedure with difficult puncture in late chemotherapy or fear of puncture with a low success rate in treating leukemia (Barbi et al, 2005;Nagel et al, 2008;Nguyen et al, 2010). Therefore, it is necessary to develop an easily applicable method to relieve the patients' pain.…”

Section: Introductionmentioning

confidence: 99%

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

et al. 2015

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ABSTRACT. This study explored the sedative and analgesic effects of fentanyl combined with propofol via an intrathecal chemotherapy injection for acute leukemia (acute lymphocytic leukemia or acute myelocytic leukemia) among children, to relieve pain and difficulty during intrathecal injection, improve treatment compliance, increase the success rate of single puncture, and reduce procedure failure, with the aim of developing a painless procedure for children with acute leukemia. Fifty person-times received fentanyl combined with propofol via an intrathecal chemotherapy injection among the hospitalized children with leukemia. The patients' cooperation with the procedure, response to the medication, dosages of fentanyl and propofol, reaction to the procedures, wake-up time, and changes in oxygen saturation (SpO 2 ), heart rate (HR), respiration, and blood pressure (BP) before, during, and after the procedures were observed. The doctors who performed the procedures assessed the quality of sedation and analgesia. In the treatment group, the patients were quiet during the lumbar puncture and intrathecal injection, showing good sedation and analgesia. HR and respiration decreased slightly. There were no changes in SpO 2 and BP. No obvious respiratory depression occurred with proper dosages. Only a few patients showed stertorous respiration, which stopped soon after the procedures. In the control group, the patients were agitated, crying, and not cooperative before and during the procedures, which made the procedures very difficult. During intrathecal injection, pain obviously reduced and the success rate of single lumbar puncture increased. It is safe and effective to apply fentanyl combined with propofol for sedation and analgesia.

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Section: Introductionmentioning

confidence: 99%

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

et al. 2015

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“…Addition of fentanyl to propofol sedation improved analgesia (Nagel et al, 2008 Level II) and satisfaction (Cechvala et al, 2008 Level II) in children with leukaemia undergoing bone marrow aspirations and lumbar punctures. Oral transmucosal fentanyl reduced pain scores (Schechter et al, 1995 Level IV).…”

Section: Lumbar Puncture and Bone Marrow Aspirationmentioning

confidence: 99%

Safety of opioid patch initiation in Australian residential aged care

Gadzhanova

Roughead

Pont

2015

Medical Journal of Australia

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Objective: To explore opioid use by aged care facility residents before and after initiation of transdermal opioid patches. Design: A cross‐sectional cohort study, analysing pharmacy data on individual patient supply between 1 July 2008 and 30 September 2013. Setting: Sixty residential aged care facilities in New South Wales. Participants: Residents receiving an initial opioid patch during the study period. Main outcome measure: The proportion of residents who were opioid‐naive in the 4 weeks prior to patch initiation was determined. In addition, the patch strength at initiation and the daily dose of transdermal patches and of additional opioids 1 month after initiation were determined. Results: An opioid patch was initiated in 596 of 5297 residents (11.3%: 2.6% fentanyl, 8.7% buprenorphine) in the 60 residential aged care facilities. The mean age at initiation was 87 years, and 74% of the recipients were women. The proportion of recipients who were opioid‐naive before patch initiation was 34% for fentanyl and 49% for buprenorphine. Most were initiated at the lowest available patch strength, and the dose was up‐titrated after initiation. Around 15% of fentanyl users and 10% of buprenorphine users needed additional regular opioids after patch initiation. Conclusions: The results suggest some inappropriate initiation of opioid patches in Australian residential aged care facilities. Contrary to best practice, a third of residents initiated on fentanyl patches were opioid‐naive in the 4 weeks before initiation.

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“…Ketamine, fentanyl, and midazolam can be administered by a nonanesthesiologist outside of the operating room when proper monitoring and trained personnel are available. 7,[24][25][26][27][29][30][31][32] It is essential to continue using CBI with these children to develop coping skills over time, even when moderate sedation is used.…”

Section: Moderate Sedationmentioning

confidence: 99%

“…24 Administering ondansetron with the analgesia agents reduces vomiting or retching after the procedure. 30 The risk for ketamine complications is dose and age dependent. In a 2009 meta-analysis on emergency department procedural sedation, ketamine caused increased airway or respiratory adverse events, emesis, and recovery agitation when administered in an unusually high intravenous dose (initial dose Z2.5 mg/kg or total dose Z5.0 mg/kg).…”

Section: Age Range Techniquesmentioning

confidence: 99%

Managing Painful Procedures in Children With Cancer

Hockenberry

McCarthy

Taylor

et al. 2011

Journal of Pediatric Hematology/Oncology

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Children with cancer experience repeated invasive and painful medical procedures. Pain and distress does not decrease with repeated procedures and may worsen if pain is not adequately managed. In 1990, the first recommendations on the management of pain and anxiety associated with procedures for children with cancer were published. Guiding principles described in the recommendations continue to hold true today: maximize comfort and minimize pain, use nonpharmacologic and pharmacologic interventions, prepare the child and family, consider the developmental age of the child, support family and child involvement, assure provider competency in performing procedures and sedation, and use appropriate monitoring to assure safety. This article reviews these key components for managing painful procedures in children and reviews the latest pharmacological and nonpharmacological interventions most effective in minimizing pain and discomfort.

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Pediatric oncology sedation trial (POST): A double‐blind randomized study

Cited by 19 publications

References 15 publications

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

Safety of opioid patch initiation in Australian residential aged care

Managing Painful Procedures in Children With Cancer

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