Propofol or propofol–alfentanil anesthesia for painful procedures in the pediatric oncology ward

Heijne, Margareta Von; Bredlöv, Britt; Söderhäll, Stefan; Olsson, Gunnar

doi:10.1111/j.1460-9592.2004.01279.x

Cited by 31 publications

(19 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several TIVA regimens for pediatric oncology procedures have been reported as combinations of propofol and ketamine or opioids (fentanyl [2, 5], remifentanil [15], alfentanil [4], and morphine [16]). The Pediatric Sedation Research Consortium analyzed 49,836 propofol sedation/anesthesia encounters outside of the operating room at 37 hospitals and found that propofol alone was most commonly used (80% of cases) and that opioids were the most common addition to TIVA with propofol (~10% of cases) [17].…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Crossover Evaluation of Three Anesthetic Regimens for Painful Procedures in Children with Cancer

Anghelescu

Burgoyne

Faughnan

et al. 2013

The Journal of Pediatrics

View full text Add to dashboard Cite

Objectives To identify the most effective sedation regimen for bone marrow aspiration and lumbar puncture procedures with a prospective trial of 3 combinations of sedation/analgesia. Study design In this double-blind crossover study, we randomly assigned 162 children with acute lymphoblastic leukemia or lymphoblastic lymphoma to receive fentanyl 1 mcg/kg, fentanyl 0.5 mcg/kg, or placebo, in addition to propofol and topical anesthetic for 355 procedures. Results We found no significant differences among the three regimens in the frequency of pain (pain score >0) or severe pain (PS ≥5) during recovery, or a >20% increase in hemodynamic/respiratory variables during anesthesia. Treatment with fentanyl 1 mcg/kg was associated with a lower frequency of movement during procedure as compared with treatment with fentanyl 0.5mcg/kg (P = 0.0476) or treatment with placebo (P = 0.0545). The placebo group required longer time to recover (median, 18 minutes) as compared with the fentanyl 0.5 mcg/kg group (median, 9 minutes) (median difference 2.0, P = 0.007) and the fentanyl 1 mcg/kg (median 8 minutes), (median difference 2.0, P = 0.15). The placebo group also required larger total dose of propofol (median 5 mg/kg) as compared with that of the fentanyl 1 mcg/kg group (median, 3.5 mg/kg) and the fentanyl 0.5 mcg/kg group (median 3.5 mg/kg) (median differences 1.5, P <0.00005, in both comparisons). Conclusion The addition of fentanyl 1 mcg/kg to propofol for brief painful procedures reduces movement, propofol dose, and recovery time.

show abstract

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Crossover Evaluation of Three Anesthetic Regimens for Painful Procedures in Children with Cancer

Anghelescu

Burgoyne

Faughnan

et al. 2013

The Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

“…Topical 5% lidocaine and prilocaine cream (Emla) may be effective, if it is applied several hours in advance of propofol 64 ; it was ineffective when applied 1 h in advance. 65 In a placebo-controlled study in 180 adults, intravenous preinjection of diphenhydramine 20 mg or lidocaine 40 mg reduced the incidence of propofol-induced pain from 42 to 5.0% and 3.3%, respectively.…”

Section: Other Drugsmentioning

confidence: 99%

Management of pain during injection of propofol

Aronson¹

2014

Adverse Drug Reaction Bulletin

View full text Add to dashboard Cite

The results of this narrative review and published systematic reviews suggest that to reduce the risk of pain during injection with propofol one should use a lipid emulsion of propofol, injected into a large vein, preceded by lidocaine 0.5 mg/kg with venous compression for 30-120 s. The addition of other compounds can also be recommended, and ketamine 0.4 mg/kg (adult dose) may be the additional drug of choice, particularly because the combination of ketamine and propofol (ketofol) has added therapeutic benefits. In children Emla cream is an option, but to be effective it must be applied about 4 h before propofol is injected. Dose relationStudies of the most effective dose of lidocaine have given varying results. Doses used have varied from 5 to 100 mg, in strengths varying from 0.5 to 2%. Although no dose relation has been shown in some studies, 54,55 there is evidence, as would be expected, of dose-relatedness, 56,57 a dose of around 60 mg in adults having maximum efficacy. 58

show abstract

“…Therefore, this agent must be administered in a controlled setting with experienced personnel trained in advanced airway management skills with resuscitative equipment readily available. 9,21,33,51,52,55,57,58 HOW TO CHOOSE THE SEDATION CATEGORY There are several choices for sedation that can be administered in outpatient and inpatient cancer settings. Minimal sedation can be safely administered in the clinic or an inpatient unit.…”

Section: General Anesthesiamentioning

confidence: 99%

Managing Painful Procedures in Children With Cancer

Hockenberry

McCarthy

Taylor

et al. 2011

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

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.

show abstract

Propofol or propofol–alfentanil anesthesia for painful procedures in the pediatric oncology ward

Abstract: If anesthesia is chosen for invasive procedures, this study suggest that propofol anesthesia in the POW is preferred by parents and children.

Cited by 31 publications

References 20 publications

Prospective Randomized Crossover Evaluation of Three Anesthetic Regimens for Painful Procedures in Children with Cancer

Prospective Randomized Crossover Evaluation of Three Anesthetic Regimens for Painful Procedures in Children with Cancer

Management of pain during injection of propofol

Managing Painful Procedures in Children With Cancer

Contact Info

Product

Resources

About