2.50
Hdl Handle:
http://hdl.handle.net/10755/203155
Type:
Presentation
Title:
An Evidence-Based Approach to Sedation in Children With Cancer
Abstract:
(Improvement Science Research Network) Background: 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. Purpose: The last published guidelines for procedure management in children with cancer was almost 20 years ago, an evidence-based (EB) review was undertaken to develop a new guideline for care of children with cancer undergoing sedation for procedures. Methods: Search engines were searched, from 1995 to 2010. 49 articles were reviewed. The GRADE criteria were used to evaluate the quality of research articles to develop this guideline. Results: Based on the review of the evidence, the following strong recommendations were established with moderate quality evidence. To reduce development of anticipatory anxiety, patients should receive maximum treatment of pain/distress for initial procedures. Factors such as age, cognitive level, length of time since diagnosis and experience with previous procedures impact the patient’s anxiety. Education and preparation of the family and child prior to, during and after procedures helps minimize procedural anxiety. The information should be developmentally appropriate and interventions should be individualized to meet the needs of the patient. Cognitive behavioral interventions should be utilized to decrease pain and anxiety. Such methods should be used in conjunction with local anesthesia, sedation and analgesia. Local anesthesia should be used with sedation and analgesia. For first procedures, deep or general sedation should be used. Propofol is a safe and effective agent for deep sedation. Midazolam, fentanyl, and ketamine are safe and effective agents for moderate sedation. Conclusion: This EB approach found essential components for a procedure management program must include effective parent teaching/education, procedure preparation for both parent and child, and appropriate analgesia and sedation. While new and better pharmacologic agents now exist, management of painful procedures in children with cancer must be tailored to the individual patient by effective communication between the child, parents and medical staff of successful multi-modal interventions. [© Improvement Science Research Network, 2011. http://www.improvementscienceresearch.net/.]
Keywords:
Sedation; Cancer
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Improvement Science Research Network

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAn Evidence-Based Approach to Sedation in Children With Canceren_GB
dc.identifier.urihttp://hdl.handle.net/10755/203155-
dc.description.abstract(Improvement Science Research Network) Background: 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. Purpose: The last published guidelines for procedure management in children with cancer was almost 20 years ago, an evidence-based (EB) review was undertaken to develop a new guideline for care of children with cancer undergoing sedation for procedures. Methods: Search engines were searched, from 1995 to 2010. 49 articles were reviewed. The GRADE criteria were used to evaluate the quality of research articles to develop this guideline. Results: Based on the review of the evidence, the following strong recommendations were established with moderate quality evidence. To reduce development of anticipatory anxiety, patients should receive maximum treatment of pain/distress for initial procedures. Factors such as age, cognitive level, length of time since diagnosis and experience with previous procedures impact the patient’s anxiety. Education and preparation of the family and child prior to, during and after procedures helps minimize procedural anxiety. The information should be developmentally appropriate and interventions should be individualized to meet the needs of the patient. Cognitive behavioral interventions should be utilized to decrease pain and anxiety. Such methods should be used in conjunction with local anesthesia, sedation and analgesia. Local anesthesia should be used with sedation and analgesia. For first procedures, deep or general sedation should be used. Propofol is a safe and effective agent for deep sedation. Midazolam, fentanyl, and ketamine are safe and effective agents for moderate sedation. Conclusion: This EB approach found essential components for a procedure management program must include effective parent teaching/education, procedure preparation for both parent and child, and appropriate analgesia and sedation. While new and better pharmacologic agents now exist, management of painful procedures in children with cancer must be tailored to the individual patient by effective communication between the child, parents and medical staff of successful multi-modal interventions. [© Improvement Science Research Network, 2011. http://www.improvementscienceresearch.net/.]en_GB
dc.subjectSedationen_GB
dc.subjectCanceren_GB
dc.date.available2012-01-16T10:57:57Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T10:57:57Z-
dc.description.sponsorshipUTHSCSA Improvement Science Research Networken_GB
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