A Survey of Pain Management and Procedural Sedation Practices by Pediatric Hematology/Oncology Practitioners in China

There are many conditions in the emergency department that require pain management or procedural sedation due to significant pain or complexity. There are also a number of procedures and conditions that will require pain control or anxiolysis in children due to developmental and behavioral factors. Pain control and procedural sedation in pediatric patients can be challenging. A variety of pharmacologic agents can be utilized to minimize anxiety and control pain. These have a wide range of administration routes, including topical, oral, intravenous, intramuscular, intranasal, and regional pain control via nerve blocks. In addition, many non-pharmacologic adjuncts can be coupled with age-appropriate interaction tips to decrease the medications required. This chapter discusses pharmacologic intervention, including narcotic and non-narcotic medications, non-pharmacologic interventions, procedural sedation, and nerve blocks.

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Oncology

The Pediatric Procedural Sedation Handbook ◽

10.1093/med/9780190659110.003.0041 ◽

2018 ◽

pp. 262-268

Author(s):

Gordon Gale

Keyword(s):

Bone Marrow ◽

Local Anesthesia ◽

Minimum Amount ◽

Procedural Sedation ◽

Successful Completion ◽

Oncology Patients ◽

Unique Challenge ◽

Pediatric Hematology ◽

Children And Parents

Pediatric hematology/oncology patients present a unique challenge for procedural sedation because they frequently require repeated painful procedures (lumbar punctures and bone marrow testing) as part of their therapy. These procedures require specific positioning and some degree of immobility for successful completion. This section is a guide to accomplish these procedures with a minimum amount of anxiety and pain. Specifics for local anesthesia, positioning, sedation, and postprocedure care are outlined. Ideally, the children and parents can accept these procedures without the additional fear brought to bear by the anticipation of discomfort. The techniques described are also applicable to any infant or child undergoing these procedures.

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Book Review: Pain Management and Procedural Sedation Handbook

Anaesthesia and Intensive Care ◽

10.1177/0310057x0903700224 ◽

2009 ◽

Vol 37 (2) ◽

pp. 334-334

Author(s):

C. Hackman

Keyword(s):

Pain Management ◽

Procedural Sedation

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Pain Management and Procedural Sedation Handbook

British Journal of Anaesthesia ◽

10.1093/bja/aep112 ◽

2009 ◽

Vol 102 (6) ◽

pp. 894-895

Author(s):

I. Power

Keyword(s):

Pain Management ◽

Procedural Sedation

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Procedural pain management in Italy: learning from a nationwide survey involving centers of the Italian Association of Pediatric Hematology-Oncology

Pediatric Reports ◽

10.4081/pr.2011.e34 ◽

2011 ◽

Vol 3 (4) ◽

pp. 34 ◽

Cited By ~ 2

Author(s):

Chiara Po' ◽

Franca Benini ◽

Laura Sainati ◽

Maria Immacolata Farina ◽

Simone Cesaro ◽

...

Keyword(s):

Pain Management ◽

Nationwide Survey ◽

Procedural Pain ◽

Pharmacological Treatments ◽

Future Directions ◽

Pain Experience ◽

Pediatric Hematology ◽

Critical Issues ◽

Pain State ◽

Skilled Staff

Procedural pain is an important aspect of care in pediatrics, and particularly in pediatric oncology where children often consider this to be the most painful experience during their illness. Best recommended practice to control procedural pain includes both sedative-analgesic administration and non-pharmacological treatments, practiced in an adequate and pleasant setting by skilled staff. A nationwide survey has been conducted among the Italian Centers of Pediatric Hematology-Oncology to register operators’ awareness on procedural pain, state of the art procedural pain management, operators’ opinions about pain control in their center, and possible barriers impeding sedation-analgesia administration. Based on indications in the literature, we discuss the results of the survey to highlight critical issues and suggest future directions for improvement. Future objectives will be to overcome differences depending on size, improve operators’ beliefs about the complexity of pain experience, and promote a global approach to procedural pain.

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