Reducing pain and distress related to needle procedures in children with cancer: A clinical practice guideline

被引：55

作者：

Loeffen, Erik A. H. ^{[1
]}

Mulder, Renee L. ^{[2
,3
]}

Font-Gonzalez, Anna ^{[2
,3
]}

Leroy, Piet L. J. M. ^{[4
]}

Dick, Bruce D. ^{[5
,6
]}

Taddio, Anna ^{[7
,8
,9
]}

Ljungman, Gustaf ^{[10
]}

Jibb, Lindsay A. ^{[11
]}

Tutelman, Perri R. ^{[12
]}

Liossi, Christina ^{[13
]}

Twycross, Alison ^{[14
]}

Positano, Karyn ^{[15
]}

Knops, Rutger R. ^{[3
]}

Wijnen, Marc ^{[3
]}

van de Wetering, Marianne D. ^{[3
]}

Kremer, Leontien C. M. ^{[2
,3
]}

Dupuis, L. Lee ^{[7
,8
,9
]}

Campbell, Fiona ^{[16
]}

Tissing, Wim J. E. ^{[1
,3
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Beatrix Childrens Hosp, Dept Pediat Oncol Hematol, POB 30-001, NL-9700 RB Groningen, Netherlands

[2] Univ Amsterdam, Amsterdam UMC, Emma Childrens Hosp, Dept Pediat Oncol, Amsterdam, Netherlands

[3] Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands

[4] Maastricht Univ, Med Ctr, Dept Pediat, Maastricht, Netherlands

[5] Univ Alberta, Dept Anesthesiol & Pain Med, Edmonton, AB, Canada

[6] Univ Alberta, Dept Psychiat & Pediat, Edmonton, AB, Canada

[7] Univ Toronto, Leslie Dan Fac Pharm, Toronto, ON, Canada

[8] Hosp Sick Children, Dept Pharm, Toronto, ON, Canada

[9] Hosp Sick Children, Res Inst, Toronto, ON, Canada

[10] Uppsala Univ, Dept Womens & Childrens Hlth, Pediat Oncol, Uppsala, Sweden

[11] Univ Ottawa, Fac Hlth Sci, Sch Nursing, Ottawa, ON, Canada

[12] IWK Hlth Ctr, Ctr Pediat Pain Res, Halifax, NS, Canada

[13] Great Ormond St Hosp Children NHS Fdn Trust, Pediat Psychol, London, England

[14] London South Bank Univ, Sch Hlth & Social Care, London, England

[15] Univ Toronto, Toronto, ON, Canada

[16] Hosp Sick Children, Dept Anesthesia & Pain Med, Toronto, ON, Canada

来源：

EUROPEAN JOURNAL OF CANCER | 2020年 / 131卷

关键词：

Pediatric oncology; Procedural pain; Supportive care; Guideline; COGNITIVE-BEHAVIOR THERAPY; PEDIATRIC ONCOLOGY; LUMBAR PUNCTURE; GENERAL-ANESTHESIA; SUPPORTIVE CARE; SEDATION; EFFICACY; DISTRACTION; MANAGEMENT; HYPNOSIS;

D O I：

10.1016/j.ejca.2020.02.039

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Children with cancer often undergo long treatment trajectories involving repeated needle procedures that potentially cause pain and distress. As part of a comprehensive effort to develop clinical practice guidelines (CPGs) to address pain prevention and management in children with cancer, we aimed to provide recommendations on the pharmacological and psychological management of procedure-related pain and distress. Methods: Of the international inter-disciplinary CPG development panel (44 individuals), two working groups including 13 healthcare professionals focused on procedural pain and distress. Grading of Recommendations Assessment, Development and Evaluation methodology was used, including the use of systematic literature reviews to inform recommendations and the use of evidence to decision frameworks. At an in-person meeting in February 2018, the guideline panel discussed these frameworks and formulated recommendations which were then discussed with a patient-parent panel consisting of 4 survivors and 5 parents. Results: The systematic reviews led to the inclusion of 48 randomised controlled trials (total number of participants = 2271). Quality of evidence supporting the recommendations ranged from very low to moderate. Strong recommendations were made for the use of topical anesthetics in all needle procedures, for offering deep sedation (DS)/general anesthesia (GA) to all children undergoing lumbar puncture, for the use of DS/GA in major procedures in children of all ages, for the use of hypnosis in all needle procedures and for the use of active distraction in all needle procedures. Conclusion: In this CPG, an evidence-based approach to manage procedure-related pain and distress in children with cancer is presented. As children with cancer often undergo repeated needle procedures during treatment, prevention and alleviation of procedure-related pain and distress is of the utmost importance to increase quality of life in these children and their families. (C) 2020 The Authors. Published by Elsevier Ltd.

引用

页码：53 / 67

页数：15

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