Diagnostic Painful Procedures and Pain Care for the Children with Leukemia

Abstract

We mailed a questionnaire to pediatric hematologists in 22 hospitals participating in the Children's Cancer and Leukemia Study Group on pain care, anesthesia and informed assent for painful procedures (spinal puncture and bone marrow aspiration). When performing spinal puncture, 15 hospitals (68.2%) provide general anesthesia to 3-year-old patients and two hospitals (9.1%) do not. Of the 22 hospitals surveyed, nine (40.9%) provide local anesthesia and seven (31.8%) do not provide anesthesia to 14-year-old patients during spinal puncture. When performing bone marrow aspiration, 16 hospitals provide general anesthesia to 3-year-old patients but 15 hospitals only provide local anesthesia to 14-year-old patients. Monitoring and management of patients during and after sedation also differed between hospitals. Of 22 hospitals, 11 hospitals ask family members to check the patient's state after sedation. Before these procedures, all hospitals explain the procedures to 14-year-old patients. Eight hospitals do not explain the procedure to 5-year-old patients. These results indicate that the guidelines on pain care for painful procedures must be considered for children with leukemia.