Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener Medizinische Wochenschrift 3-4/2019

01.12.2017 | original article

Bone marrow aspirations in oncological patients: experience from an in-house standard in paediatrics

verfasst von: Dr. Harald Sauer, Stefan Graeber, Ulla Lieser, Juergen Foell

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 3-4/2019

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Background

Nearly all paediatric patients require deep sedation when undergoing bone marrow aspiration (BMA). We analyzed the data from our protocols documented in a standardised procedure for bone marrow puncture over a period of 2 years.

Methods

Our standard included the documentation of personal data as well as vital parameters. In addition, we documented all medications administered, potential complications and required intervention measures, as necessary.

Results

A total of 107 protocols were available for the evaluation. Our standard covered the usage of midazolam and S‑ketamine and resulted in complications in just 9 patients, which could be remedied using simple measures. For both active substances, the dosage necessary to reach sufficient deep analgosedation was significantly higher for patients under 24 months of age.

Conclusions

Our standard for BMA provides a practical and feasible procedure. In addition to good examination conditions, our standard also helps ensure the safety of our patients.
Literatur
1.
Zurück zum Zitat American Society of Anesthesiologists. Continuum of Depth of Sedation—Definition of General Anesthesia and Levels of Sedation/Analgesia. ASA House of Delegates on October 13, 1999. American Society of Anesthesiologists. Continuum of Depth of Sedation—Definition of General Anesthesia and Levels of Sedation/Analgesia. ASA House of Delegates on October 13, 1999.
2.
Zurück zum Zitat American Academy of Pediatrics and the American Academy of Pediatric Dentistry. Guideline for monitoring and managment of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics. 2012;129:e1103. 2006, Reaffirmed 2011. CrossRef American Academy of Pediatrics and the American Academy of Pediatric Dentistry. Guideline for monitoring and managment of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics. 2012;129:e1103. 2006, Reaffirmed 2011. CrossRef
3.
Zurück zum Zitat Sauer H, Grünzinger L, Pfeifer J, Lieser U, Abdul-Khaliq H. Sedation and analgosedation performed by pediatricians—experience made with the implementation of an in-house sedation standard. Wien Med Wochenschr. 2016;166(1):54–61. CrossRef Sauer H, Grünzinger L, Pfeifer J, Lieser U, Abdul-Khaliq H. Sedation and analgosedation performed by pediatricians—experience made with the implementation of an in-house sedation standard. Wien Med Wochenschr. 2016;166(1):54–61. CrossRef
4.
Zurück zum Zitat American Society of Anesthesiologists. Advisory on granting privileges for deep sedation to non-anesthesiologists sedation practitioners; Approved by the ASA House of Delegates on October 20, 2010. American Society of Anesthesiologists. Advisory on granting privileges for deep sedation to non-anesthesiologists sedation practitioners; Approved by the ASA House of Delegates on October 20, 2010.
6.
Zurück zum Zitat Krauss B, Green S. Procedural sedation and analgesia in children. Lancet. 2006;367:766–80. CrossRef Krauss B, Green S. Procedural sedation and analgesia in children. Lancet. 2006;367:766–80. CrossRef
8.
Zurück zum Zitat Hjortholm N, Jaddini E, Halaburda K, Snarski E. Strategies of pain reduction during the bone marrow biopsy. Ann Hematol. 2013;92:145–9. CrossRef Hjortholm N, Jaddini E, Halaburda K, Snarski E. Strategies of pain reduction during the bone marrow biopsy. Ann Hematol. 2013;92:145–9. CrossRef
10.
Zurück zum Zitat Kato Y, Maeda M, Aoki Y, Ishii E, Ishida Y, Kiyotani C, Goto S, Sakaguchi S, Sugita K, Tokuyama M, Nakadate H, Kikuchi A, Tsuchida M, Ohara A. Pain management during bone marrow aspiration and biopsy in pediatric cancer patients. Pediatr Int. 2014;56:354–9. CrossRef Kato Y, Maeda M, Aoki Y, Ishii E, Ishida Y, Kiyotani C, Goto S, Sakaguchi S, Sugita K, Tokuyama M, Nakadate H, Kikuchi A, Tsuchida M, Ohara A. Pain management during bone marrow aspiration and biopsy in pediatric cancer patients. Pediatr Int. 2014;56:354–9. CrossRef
11.
Zurück zum Zitat Ljungman G, Gordh T, Sörensen S, Kreuger A. Lumbar puncture in pediatric oncology: conscious sedation vs. general anesthesia. Med Pediatr Oncol. 2001;36(3):372–9. CrossRef Ljungman G, Gordh T, Sörensen S, Kreuger A. Lumbar puncture in pediatric oncology: conscious sedation vs. general anesthesia. Med Pediatr Oncol. 2001;36(3):372–9. CrossRef
12.
Zurück zum Zitat Reeves S, Havidich J, Tobin P. Conscious sedation of children with propofol is anything but conscious. Pediatrics. 2004;114(1):e74–6. CrossRef Reeves S, Havidich J, Tobin P. Conscious sedation of children with propofol is anything but conscious. Pediatrics. 2004;114(1):e74–6. CrossRef
13.
Zurück zum Zitat Sievers T, Yee J, Foley M, Blanding P, Berde C. Midazolam for conscious sedation during pediatric oncology procedures: safety and recovery parameters. Pediatrics. 1991;88:1172–9. PubMed Sievers T, Yee J, Foley M, Blanding P, Berde C. Midazolam for conscious sedation during pediatric oncology procedures: safety and recovery parameters. Pediatrics. 1991;88:1172–9. PubMed
14.
Zurück zum Zitat Cheuk D, Wong W, Ma E, Lee T, Ha S, Lau Y, Chan G. Use of midazolam and ketamine as sedation for children undergoing minor operative procedures. Support Care Cancer. 2005;13:1001–9. CrossRef Cheuk D, Wong W, Ma E, Lee T, Ha S, Lau Y, Chan G. Use of midazolam and ketamine as sedation for children undergoing minor operative procedures. Support Care Cancer. 2005;13:1001–9. CrossRef
15.
Zurück zum Zitat Karapinar B, Yilmaz D, Demirag K, Kantar M. Sedation with intravenous ketamine and midazolam for painful procedures in children. Pediatr Int. 2006;48:146–51. CrossRef Karapinar B, Yilmaz D, Demirag K, Kantar M. Sedation with intravenous ketamine and midazolam for painful procedures in children. Pediatr Int. 2006;48:146–51. CrossRef
16.
Zurück zum Zitat Borker A, Ambulkar I, Gopal R, Advani S. Safe and efficacious use of procedural sedation and analgesia by non-anesthesiologists in a pediatric hematology-oncology unit. Indian Pediatr. 2006;43(4):309–14. PubMed Borker A, Ambulkar I, Gopal R, Advani S. Safe and efficacious use of procedural sedation and analgesia by non-anesthesiologists in a pediatric hematology-oncology unit. Indian Pediatr. 2006;43(4):309–14. PubMed
17.
Zurück zum Zitat Evans D, Turnham L, Barbour K, Kobe J, Wilson L, Vandebeek C, Montgomery C, Rogers P. Intravenous ketamine sedation for painful oncology procedures. Pediatr Anesth. 2005;15:131–8. CrossRef Evans D, Turnham L, Barbour K, Kobe J, Wilson L, Vandebeek C, Montgomery C, Rogers P. Intravenous ketamine sedation for painful oncology procedures. Pediatr Anesth. 2005;15:131–8. CrossRef
18.
Zurück zum Zitat Nejati A, Moharari R, Ashraf H, Labaf A. Ketamine/propofol versus midazolam/fentanyl for procedural sedation and analgesia in the emergency department: a randomized, prospective, double-blind trial. Acad Emerg Med. 2011;18(8):800–6. CrossRef Nejati A, Moharari R, Ashraf H, Labaf A. Ketamine/propofol versus midazolam/fentanyl for procedural sedation and analgesia in the emergency department: a randomized, prospective, double-blind trial. Acad Emerg Med. 2011;18(8):800–6. CrossRef
19.
Zurück zum Zitat da Silva P, de Aguiar V, Waisberg D, Passos R, Park M. Use of ketofol for procedural sedation and analgesia in children with hematological diseases. Pediatr Int. 2011;53:62–7. CrossRef da Silva P, de Aguiar V, Waisberg D, Passos R, Park M. Use of ketofol for procedural sedation and analgesia in children with hematological diseases. Pediatr Int. 2011;53:62–7. CrossRef
20.
Zurück zum Zitat Andolfatto G, Willman E. A prospective case series of pediatric procedural sedation and analgesia in the emergency department using single-syringe ketamine-propofol combination (ketofol). Acad Emerg Med. 2010;17:194–201. CrossRef Andolfatto G, Willman E. A prospective case series of pediatric procedural sedation and analgesia in the emergency department using single-syringe ketamine-propofol combination (ketofol). Acad Emerg Med. 2010;17:194–201. CrossRef
Metadaten
Titel
Bone marrow aspirations in oncological patients: experience from an in-house standard in paediatrics
verfasst von
Dr. Harald Sauer
Stefan Graeber
Ulla Lieser
Juergen Foell
Publikationsdatum
01.12.2017
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 3-4/2019
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-017-0611-1