Anesthetic management of children undergoing hematologic-oncologic procedures outside the operating room.
OBJECTIVE
There is an increasing demand on anesthetic services to provide care for children undergoing hematologic-oncologic procedures outside the operation room; in particular, to mitigate the pain and unpleasant side-effects of these treatments. This review provides an update of the latest findings on this topic.


RESULTS
An Italian survey of the management of procedural pain in children undergoing hematologic-oncologic interventions indicates that international guidelines are still not completely realized. It is essential to weigh safety concerns against patient comfort when deciding where the procedure will take place and who will perform it. An approach that addresses individual patient as well as institutional issues is optimum. Nonpharmacologic interventions combined with standard pharmacological ones are essential to reduce fear and distress in the children and their relatives. Psychological interactions as well as the child's development have to be considered. Special training for providers and an interdisciplinary approach are likely to be effective in improving treatment modalities and quality.


CONCLUSIONS
Treatment of children undergoing hematologic-oncologic procedures outside the operation room is challenging. Expertise and high standards are essential to assure patient safety.
Department of Anesthesiology and Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany. goeters@uni-muenster.de
Christiane
C
Goeters
D000556:Ambulatory Surgical Procedures; D000758:Anesthesia / Q000379:methods*; D002648:Child; D016292:Procedural Sedation; D019337:Hematologic Neoplasms / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D009873:Operating Rooms; D059408:Pain Management