Arch Dis Child 2001;85:12-15 ( July )

Article

Invasive procedures carried out in conscious children: contrast between North American and European paediatric oncology centres R D W Hain^a, C Campbell^b

^a Paediatric Palliative Care, University of Wales College of Medicine, Llandough Hospital, Penarth CF64 2XX, UK, ^b Children's Hospital of Eastern Ontario, Ottawa, Canada

Correspondence to: Dr Hain email: hainrd{at}cardiff.ac.uk

Accepted 8 March 2001

AIMTo define practice in managing repeated invasive procedures in selected paediatric oncology centres in North America and Europe, especially the United Kingdom; to define and contrast concerns that shape policy making, and to contrast practice, particularly regarding procedures performed on conscious patients.
METHODSPostal survey: 118 centres of the Pediatric Oncology Group and the United Kingdom Children's Cancer Study Group received questionnaires.
RESULTS68 questionnaires (58%) were returned (52 from North America, 12 from Europe). For all procedures, North American centres tended to use less effective techniques than European, especially for bone marrow procedures. Many North American centres reported performing these on conscious patients on at least three quarters (25%) or half (30%) the occasions. In contrast, corresponding figures for the European centres were 6% and 0%.
CONCLUSIONSMany bone marrow procedures are still carried out in the conscious patient despite the safety and effectiveness of modern anaesthetic and deep sedation techniques. There appears to be a greater reluctance to offer these to patients in North American centres than in European ones. This may reflect a misperception that the risks of adverse effects are high. Several non-pharmacological techniques are used, but they remain uncommon.


Keywords: paediatric oncology; pain relief; invasive investigation procedures

---

© 2001 by Archives of Disease in Childhood
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Arch. Dis. Child. 2001 85: 0. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Mantadakis, E., Katzilakis, N., Foundoulaki, E., Kalmanti, M. (2009). Moderate Intravenous Sedation With Fentanyl and Midazolam for Invasive Procedures in Children With Acute Lymphoblastic Leukemia. Journal of Pediatric Oncology Nursing 26: 217-222 [Abstract]  
• American Academy of Pediatrics, , American Academy of Pediatric Dentistry, , Cote, C. J., Wilson, S., the Work Group on Sedation, (2006). Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update. Pediatrics 118: 2587-2602 [Abstract] [Full Text]  
• Powers, K. S., Nazarian, E. B., Tapyrik, S. A., Kohli, S. M., Yin, H., van der Jagt, E. W., Sullivan, J. S., Rubenstein, J. S. (2005). Bispectral Index as a Guide for Titration of Propofol During Procedural Sedation Among Children. Pediatrics 115: 1666-1674 [Abstract] [Full Text]  
• Glaisyer, H. R., Sury, M. R. J. (2005). Recovery After Anesthesia for Short Pediatric Oncology Procedures: Propofol and Remifentanil Compared with Propofol, Nitrous Oxide, and Sevoflurane. Anesth. Analg. 100: 959-963 [Abstract] [Full Text]  
• Cravero, J. P., Blike, G. T. (2004). Review of Pediatric Sedation. Anesth. Analg. 99: 1355-1364 [Abstract] [Full Text]  
• Mercadante, S. (2004). Cancer pain management in children. Palliat Med 18: 654-662 [Abstract]  
• Hockenberry, M. (2004). Symptom Management Research in Children With Cancer. Journal of Pediatric Oncology Nursing 21: 132-136 [Abstract]  
• Sammons, H M, McIntyre, J, Choonara, I (2004). Research in general paediatrics. Arch. Dis. Child. 89: 408-410 [Full Text]  
• Franck, L. S. (2003). Nursing management of children's pain: Current evidence and future directions for research. Journal of Research in Nursing 8: 330-353 [Abstract]  
• Crock, C, Olsson, C, Phillips, R, Chalkiadis, G, Sawyer, S, Ashley, D, Camilleri, S, Carlin, J, Monagle, P (2003). General anaesthesia or conscious sedation for painful procedures in childhood cancer: the family's perspective. Arch. Dis. Child. 88: 253-257 [Abstract] [Full Text]