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Propofol/alfentanil and propofol/ketamine procedural sedation in children with acute lymphoblastic leukaemia: safety, efficacy and their correlation with pain neuromediator expression

2009; Wiley; Volume: 19; Issue: 2 Linguagem: Inglês

10.1111/j.1365-2354.2008.01006.x

1365-2354

Antonio Chiaretti, Antonio Ruggiero, Giovanni Barone, A. Antonelli, Ilaria Lazzareschi, Orazio Genovese, S Paiano, Maria Pia Sammartino, Palma Maurizi, Riccardo Riccardi,

Anesthesia and Neurotoxicity Research

European Journal of Cancer CareVolume 19, Issue 2 p. 212-220 Propofol/alfentanil and propofol/ketamine procedural sedation in children with acute lymphoblastic leukaemia: safety, efficacy and their correlation with pain neuromediator expression A. CHIARETTI md , A. CHIARETTI md Paediatric Intensive Care Unit, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorA. RUGGIERO md , Corresponding Author A. RUGGIERO md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalyAntonio Ruggiero, Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome, Italy (e-mail: ruggiero@rm.unicatt.it). Search for more papers by this authorG. BARONE md , G. BARONE md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorA. ANTONELLI phd, professor, A. ANTONELLI phd, professor Paediatric Intensive Care Unit, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorI. LAZZARESCHI md , I. LAZZARESCHI md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorO. GENOVESE md , O. GENOVESE md Paediatric Intensive Care Unit, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorS. PAIANO md , S. PAIANO md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorM. SAMMARTINO md , M. SAMMARTINO md Department of Anaesthesia, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorP. MAURIZI md , P. MAURIZI md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorR. RICCARDI md, professor, R. RICCARDI md, professor Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this author A. CHIARETTI md , A. CHIARETTI md Paediatric Intensive Care Unit, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorA. RUGGIERO md , Corresponding Author A. RUGGIERO md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalyAntonio Ruggiero, Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome, Italy (e-mail: ruggiero@rm.unicatt.it). Search for more papers by this authorG. BARONE md , G. BARONE md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorA. ANTONELLI phd, professor, A. ANTONELLI phd, professor Paediatric Intensive Care Unit, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorI. LAZZARESCHI md , I. LAZZARESCHI md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorO. GENOVESE md , O. GENOVESE md Paediatric Intensive Care Unit, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorS. PAIANO md , S. PAIANO md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorM. SAMMARTINO md , M. SAMMARTINO md Department of Anaesthesia, 'A. Gemelli' Hospital, Catholic University of Rome, RomeSearch for more papers by this authorP. MAURIZI md , P. MAURIZI md Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this authorR. RICCARDI md, professor, R. RICCARDI md, professor Division of Paediatric Oncology, 'A. Gemelli' Hospital, Catholic University of Rome, Rome ItalySearch for more papers by this author First published: 04 February 2010 https://doi.org/10.1111/j.1365-2354.2008.01006.xCitations: 25Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract CHIARETTI A., RUGGIERO A., BARONE G., ANTONELLI A., LAZZARESCHI I., GENOVESE O., PAIANO S., SAMMARTINO M., MAURIZI P. & RICCARDI R. (2010) European Journal of Cancer Care19, 212–220Propofol/alfentanil and propofol/ketamine procedural sedation in children with acute lymphoblastic leukaemia: safety, efficacy and their correlation with pain neuromediator expression Invasive procedures, such as the lumbar puncture, can cause anxiety and pain in children undergoing treatment for acute lymphoblastic leukaemia (ALL). We investigated the safety and efficacy of two different protocols for analgo-sedation in 20 children with ALL undergoing lumbar puncture. We have conducted a prospective, cross-over study. Protocol A was composed of an association between propofol and alfentanil. Protocol B consisted in the combination of propofol and ketamine. We also evaluated the levels of nerve growth factor, substance P and enkephalins in the cerebrospinal fluid of these patients. All patients showed a satisfactory sedation and analgesia. We found a statistically significant difference of vital parameters between protocol A and protocol B, while there were no significant differences between sedation scores and the other parameters evaluated. Patients in protocol A showed a higher incidence of major side effects, such as respiratory depression. Pain neuromediator levels did not show any statistical difference between the two groups. This study shows that both protocols are effective to obtain a good sedation and analgesia in children with ALL undergoing lumbar puncture, but the association between propofol and ketamine appears to be safer due to the lower incidence of side effects. Citing Literature Volume19, Issue2March 2010Pages 212-220 RelatedInformation