Pain during treatment procedures is often identified as the most distressing aspect of the entire cancer experience for a child with cancer. The use of conscious sedation may reduce this procedure-related pain and distress. A clinical practice protocol is necessary to maximize the efficacy and safety of conscious sedation use. In this article, the processes of developing and implementing a conscious sedation protocol for pediatric oncology patients undergoing painful procedures are presented. The protocol itself is included. A review of the literature on conscious sedation is presented, and implications for pediatric oncology nursing practice are discussed.
Get full access to this article
View all access options for this article.
References
1.
McGrath PA: Pain in Children: Nature Assessment and Treatment. New York, NY, Guilford Press, 1990
2.
Miser AW: Management of pain associated with childhood cancer, in Schechter NL, Berde CB, Yaster M (eds): Pain in Infants, Children and Adolescents. Baltimore, MD, Williams & Wilkins, 1993, pp 411-424
3.
Sievers TD, Yee JD, Foley ME, et al: Midazolam for conscious sedation during pediatric oncology procedures: Safety and recovery parameters. Pediatrics88: 1172-1179, 1991
4.
Sandler ES, Weyman C., Conner K., et al: Midazolam versus fentanyl as premedication for painful procedures in children with cancer. Pediatrics89:631-634, 1992
5.
American Academy of Pediatrics Committee on Drugs: Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures . Pediatrics89:1110-1116,1992
6.
Zeltzer LK, Altman A., Cohen D., et al: Report of the subcommittee on the management of pain associated with procedures in children with cancer. Pediatrics86: 826-831, 1990 (suppl)
7.
Leahy S., Hockenberry-Eaton M., Sigler-Price K.: Clinical management of pain in children with cancer. Cancer Pract2:37-45, 1994
8.
Yaster M., Nichols DG, Deshpande J., et al: Midazolam-fentanyl intravenous sedation in children: Case report of respiratory arrest. Pediatrics86:463-467, 1990
Farrington E.: Drug information: Flumazenil. Pediatr Nurs19:163-164, 1993
11.
Ross PJ, Fochtman D.: Conscious sedation: A quality management project. J Pediatr Oncol Nurs12: 115-121, 1995
12.
Hammer SJ: Conscious sedation for infants and children in the emergency department. J Emerg Nurs18:165-167,1992
13.
Henry Ford Health System: Patient Monitoring Guidelines for the Administration of Analgesic Anesthetic and Sedative Agents During Diagnostic and Therapeutic Procedures, 1992
14.
Position statement on the role of the RN in the management of patients receiving IV conscious sedation for short-term therapeutic diagnostic or surgical procedures. AORN J55:207-208, 1992
15.
Children's Hospital of Western Ontario: Conscious Sedation Patient Monitoring, 1993
16.
Children's Hospital of Eastern Ontario: Protocol for Conscious Sedation of Oncology Patients for Painful Procedures in the Hematology/Oncology Clinic, 1992
