title: Insuflon versus subcutaneous injection for cytokine administration in children and adolescents: a randomized crossover study.
abstract: Pain is a frequent complication of subcutaneous cytokine injections in children. A randomized crossover trial was conducted to determine the least painful and preferred method of cytokine administration for children and young people. The current standard practice of subcutaneous injection was compared with the use of Insuflon (Maersk Medical, Roskilde, Denmark), a subcutaneous indwelling catheter. Children aged between 1 month-and 18 years undergoing treatment within the oncology/hematology unit of a single tertiary hospital and receiving cytokines were eligible for the study. Twenty children participated in the study, each child receiving both administration methods in random order during sequential cytokine treatment courses. There was a trend toward higher pain scores when using subcutaneous injections for drug administration compared to Insuflon. Seventy-five percent (n = 15) of the children who completed the trial and their families preferred using insuflon for subcutaneous drug administration. Consideration needs to be given, however, to those who refused to enter the study, withdrew, or continued because of a preference for subcutaneous injections. Current practice at the Women's and Children's Hospital is to allow the child and parents to choose their preferred treatment modality for subcutaneous drug administration.
authors.affiliation: University of South Australia, Hematology/Oncology Unit, Women's and Children 's Hospital, North Adelaide, South Australia, Australia. dyers@mail.wch.sa.gov.au
authors.forename: Susan L
authors.initials: SL
authors.lastname: Dyer
authors.forename: Carmel T
authors.initials: CT
authors.lastname: Collins
authors.forename: Peter
authors.initials: P
authors.lastname: Baghurst
authors.forename: Ben
authors.initials: B
authors.lastname: Saxon
authors.forename: Brooke
authors.initials: B
authors.lastname: Meachan
mesh_terms: D000293:Adolescent; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D016207:Cytokines / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000451:nursing; D006801:Humans; D007223:Infant; D007279:Injections, Subcutaneous; D008297:Male; D009859:Oncology Nursing; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D010372:Pediatrics / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D016207:Cytokines