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Safe lumbar puncture under analgo-sedation in children with acute lymphoblastic leukemia

Palma Maurizi1, Ida Russo, Daniela Rizzo

  • 1Department of Pediatric Oncology, "A. Gemelli" Hospital, UCSC, Catholic University of Rome, Largo A Gemelli, 8, 00168, Rome, Italy.

International Journal of Clinical Oncology
|February 8, 2013
PubMed

Insights

Procedural analgo-sedation using propofol and ketamine is safe and effective for children with acute lymphoblastic leukemia (ALL), improving comfort and reducing traumatic lumbar punctures.

Area of Science:

  • Pediatric Oncology
  • Anesthesiology
  • Hematology

Background:

  • Lumbar puncture (LP) is a common but painful procedure for children with acute lymphoblastic leukemia (ALL).
  • Pain and stress from LP negatively impact children's quality of life.
  • Procedural analgo-sedation may enhance comfort and reduce traumatic LPs, especially at diagnosis.

Purpose of the Study:

  • To evaluate the safety and efficacy of procedural analgo-sedation in children with ALL undergoing lumbar puncture.

Main Methods:

  • A total of 252 LPs were performed under deep sedation with propofol and ketamine in 25 children with ALL.
  • Vital parameters were monitored, and side effects were recorded.
  • Sedation efficacy was assessed using Ramsay and Children's Hospital Eastern Ontario Pain scales.

Main Results:

  • Satisfactory sedation and analgesia were achieved in all patients.
  • No significant variations in vital parameters were observed.
  • Only 1.2% of LPs resulted in traumatic effects, with no recorded side effects.

Conclusions:

  • Procedural analgo-sedation is a safe and effective method for children with ALL.
  • Implementing analgo-sedation can significantly improve patient comfort and quality of life.
  • This approach reduces the risk of traumatic lumbar punctures, particularly at diagnosis.
Abstract

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