Survey of Analgesia Use and Procedural Sedation Practice among Chinese Pediatric Oncology/Hematology Practitioners
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摘要Background
Current guidelines recommend the use of sedation and strong analgesics for children undergoing painful diagnostic/therapeutic procedures.

Objectives
To evaluate Chinese pediatric oncology practitioners’ pain management practices, and identify barriers to optimal pain control in children with cancer undergoing lumbar puncture (LP), bone marrow (BM) aspiration and BM biopsy in China.

Material and Methods
Oncology practitioners were recruited from pediatric cancer centers and professional groups in Hong Kong and mainland China through convenience sampling. Respondents completed a paper-based or electronic structured questionnaire. Chi-square test was conducted to compare practitioners’ responses across geographical regions of their practices.

Results
The sample (N=304) consisted of pediatric oncologist/hematologists (n=149, 49%), nurses (n=129, 42%), and pharmacists (n=26, 9%), who practiced in mainland China (n=264, 87%) and Hong Kong (n=40, 13%). As compared to practitioners from Hong Kong, practitioners from mainland China were less likely to administer procedural sedation during LP (100% vs 64%; P<0.0001) and BM biopsy (100% vs 73%; P<0.0001). Practitioners in mainland China identified the lack of formal training (29%) and dedicated staff (38%), and restricted access to sedative drugs (29%), as major barriers to adopting procedural sedation. The preferred first-line analgesics for moderate/severe pain in Hong Kong was morphine while mainland Chinese practitioners preferred NSAID and tramadol. Regardless of region, practitioners indicated parents’ concerns with opioid addiction (73%), safety (76%) and stigma (63%). Practitioners also reported inadequate knowledge in dosing opioids (48%) and side effects management (48%). Overall, 18% of practitioners perceived that even with existing measures, children still experienced severe pain (pain score of 7-10) during procedures.

Conclusions
A substantial proportion of Chinese oncology practitioners reported suboptimal pain management in children undergoing painful procedures. Pain control practices vary across regions. There is an urging need to empower oncology practitioners and review policies to facilitate implementation of procedural sedation in China.
出版社接受日期09.01.2019
著者Cuixia Yan, Cho Lee Wong, Celeste LY Ewig, Jingqi Zhang, Haiying Huang, Feng-gui Wei, Chi-kong Li, Hui Zhang, Yin Ting Cheung
會議名稱12th Congress of the International Society of Paediatric Oncology Asia
會議開始日03.04.2019
會議完結日06.04.2019
會議地點ADNEC
會議國家/地區阿拉伯聯合酋長國
出版年份2019
語言美式英語
關鍵詞Pediatric cancer, pain, procedural sedation, opioids, mainland China, practitioners

上次更新時間 2019-04-07 於 11:24