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Pereira LFG, Carlos RV, van Schoor A, Bosenberg A, Luna NMS, da Costa Silva R, de Fátima Bertanha B, Carmona MJC, Quintão VC. Anatomical Studies Evaluating Pediatric Regional Anesthesia: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:733. [PMID: 38929312 PMCID: PMC11201957 DOI: 10.3390/children11060733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Pediatric regional anesthesia has been driven by the gradual rise in the adoption of opioid-sparing strategies and the growing concern over the possible adverse effects of general anesthetics on neurodevelopment. Nonetheless, performing regional anesthesia studies in a pediatric population is challenging and accounts for the scarce evidence. This study aimed to review the scientific foundation of studies in cadavers to assess regional anesthesia techniques in children. METHODS We searched the following databases MEDLINE, EMBASE, and Web of Science. We included anatomical cadaver studies assessing peripheral nerve blocks in children. The core data collected from studies were included in tables and comprised block type, block evaluation, results, and conclusion. RESULTS The search identified 2409 studies, of which, 16 were anatomical studies on the pediatric population. The techniques evaluated were the erector spinae plane block, ilioinguinal/iliohypogastric nerve block, sciatic nerve block, maxillary nerve block, paravertebral block, femoral nerve block, radial nerve block, greater occipital nerve block, infraclavicular brachial plexus block, and infraorbital nerve block. CONCLUSION Regional anesthesia techniques are commonly performed in children, but the lack of anatomical studies may result in reservations regarding the dispersion and absorption of local anesthetics. Further anatomical research on pediatric regional anesthesia may guide the practice.
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Affiliation(s)
- Lucas Ferreira Gomes Pereira
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
| | - Ricardo Vieira Carlos
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
- Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Albert van Schoor
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0085, South Africa;
| | - Adrian Bosenberg
- Department of Anesthesia and Pain Management, Seattle Children’s Hospital, University of Washington, Seattle, WA 98195, USA;
| | - Natália Mariana Silva Luna
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
- Department of Medicine, Universidade Nove de Julho (UNINOVE), São Paulo 03155-000, Brazil
| | - Rebeca da Costa Silva
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
- Department of Medicine, Universidade Nove de Julho (UNINOVE), São Paulo 03155-000, Brazil
| | - Bianca de Fátima Bertanha
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
| | - Maria José Carvalho Carmona
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
| | - Vinícius Caldeira Quintão
- Discipline of Anesthesiology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil; (L.F.G.P.); (R.V.C.); (N.M.S.L.); (R.d.C.S.); (B.d.F.B.); (M.J.C.C.)
- Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
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Yamaji N, Kobayashi K, Hasegawa D, Ota E. Developing and evaluating a cancer communication picture book for children, families, and health care professionals: A mixed-methods feasibility study. Asia Pac J Oncol Nurs 2024; 11:100345. [PMID: 38188371 PMCID: PMC10770600 DOI: 10.1016/j.apjon.2023.100345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/16/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Effective communication about cancer with children is a significant challenge for healthcare professionals and families. This study aimed to create a picture book as a tool for facilitating communication about cancer and to assess its feasibility. It also demonstrated the use of mixed methods and convergent designs for intervention development. Methods The study included healthcare professionals (n = 14), children without cancer (aged 4-8 years; n = 21) and their families (n = 18), as well as children with various types of cancer, undergoing maintenance therapy or follow-up (aged 4-12 years; n = 3) and their families (n = 3). Quantitative and qualitative data were separately analyzed, and meta-inferences were made using a joint display. The picture book was refined based on feedback from healthcare professionals, and a similar iterative process was carried out with children and their families. Results Over 85% of the participants considered the picture book, along with a side book, feasible. The picture book was found to be helpful for discussing the topic of cancer with children. It also significantly improved the knowledge of children without cancer (P < 0.01). Most children expressed interest in reading it and believed it was useful for talking to others about cancer. However, some concerns were raised regarding the context and expressions in the picture book. Conclusions This study successfully assessed the feasibility of the developed picture book using a mixed methods approach, offering valuable insights into its implementation and refinement. Further research is needed to evaluate the effectiveness of its use and gather user feedback.
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Affiliation(s)
- Noyuri Yamaji
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Family Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Global Health Nursing, Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan
| | - Kyoko Kobayashi
- Child Health Nursing, Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan
- Tokyo Foundation for Policy Research, Minato-ku, Tokyo, Japan
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Pipicella JL, Vernon-Roberts A, Dutt S, Giles E, Day AS, Connor SJ, Andrews JM. Co-design and Consultation Ensure Consumer Needs Are Met: Building an eHealth Platform for Children with Inflammatory Bowel Disease. Dig Dis Sci 2023; 68:4368-4380. [PMID: 37897556 PMCID: PMC10635922 DOI: 10.1007/s10620-023-08146-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/05/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Crohn's Colitis Care is an adult inflammatory bowel disease eHealth system. Crohn's Colitis Care required additional pediatric functionality to enable life-long records and mitigate transition inadequacies. AIM This study describes and evaluates a consensus method developed to ensure consumer needs were met. METHODS Pediatric-specific functionality and associated resources considered important for inclusion were developed by a clinician consensus group. This group was divided into thematic subgroups and underwent two voting rounds. The content validity index was used to determine items reaching consensus. Children with inflammatory bowel disease and their parents were later shown a descriptive list of non-clinical inclusion topics proposed by the consensus group, and asked to vote on whether topic-related functionality and resources should be included. RESULTS The consensus process consulted 189 people in total (38 clinicians, 32 children with inflammatory bowel disease and 119 parents). There was agreement across all groups to incorporate functionality and resources pertaining to quality of life, mental health, self-management, and transition readiness; however, divergence was seen for general inflammatory bowel disease facts, your inflammatory bowel disease history, and satisfaction. Cost saw the greatest disparity, being less supported by consumers compared to clinicians. Over 75% of consumers agreed it would be okay for appointments to take longer for survey completion, and > 90% thought Crohn's Colitis Care should allow consumers to ask their treating team questions. CONCLUSIONS Widespread consumer co-design and consultation were important in unveiling differing perspectives to ensure Crohn's Colitis Care was built to support both consumer and clinician perspectives. Consumers collaborate to create a list of functionality and resources to be included in software (left), influencing the final product build (right).
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Affiliation(s)
- Joseph Louis Pipicella
- Medicine & Health (South Western Sydney Clinical School), University of New South Wales, Sydney, NSW, Australia.
- Crohn's Colitis Cure, Sydney, NSW, Australia.
- Gastroenterology, Hepatology and Inflammatory Bowel Disease Research Group, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW, 2170, Australia.
| | | | - Shoma Dutt
- Department of Gastroenterology, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, NSW, Australia
- The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Edward Giles
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Susan Jane Connor
- Medicine & Health (South Western Sydney Clinical School), University of New South Wales, Sydney, NSW, Australia
- Crohn's Colitis Cure, Sydney, NSW, Australia
- Gastroenterology, Hepatology and Inflammatory Bowel Disease Research Group, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW, 2170, Australia
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, NSW, Australia
| | - Jane Mary Andrews
- Crohn's Colitis Cure, Sydney, NSW, Australia
- Central Adelaide Local Health Network, Adelaide, SA, Australia
- Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
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Quintão VC, Carmona MJC. A call for more pediatric anesthesia research. Braz J Anesthesiol 2021; 71:1-3. [PMID: 33712245 PMCID: PMC9373261 DOI: 10.1016/j.bjane.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/10/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vinícius Caldeira Quintão
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clínicas (HC), Disciplina de Anestesiologia, São Paulo, SP, Brazil; Hospital Municipal Infantil Menino Jesus, Serviços Médicos de Anestesia SMA, São Paulo, SP, Brazil.
| | - Maria José Carvalho Carmona
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clínicas (HC), Disciplina de Anestesiologia, São Paulo, SP, Brazil
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Special issues raised by evolving areas of clinical research. ETHICAL CONSIDERATIONS WHEN PREPARING A CLINICAL RESEARCH PROTOCOL 2020. [PMCID: PMC7329119 DOI: 10.1016/b978-0-12-386935-7.00014-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Each study presents its own set of ethical considerations. Certain kinds of ethical issues are inherent in particular areas of clinical research, regardless of specific ethical questions associated with a specific study. In this chapter, some of the most common special areas of clinical research are presented, highlighting the ethical issues most frequently associated with each.
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Boles J, Daniels S. Researching the Experiences of Children with Cancer: Considerations for Practice. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E93. [PMID: 31426332 PMCID: PMC6721372 DOI: 10.3390/children6080093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/05/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022]
Abstract
Children and adolescents with cancer often participate in medical and psychosocial research throughout their diagnosis and treatment. Furthermore, this involvement frequently extends into the survivorship period. Sometimes referred to as "doubly vulnerable" research participants, children and adolescents with cancer are not only minors, but also minors facing significant medical, developmental, and psychosocial stressors associated with chronic illness. Thus, it is important to exercise care in designing and conducting research with this population; however, these considerations have not been adequately addressed in pediatric healthcare literature. Therefore, the purpose of this review is to describe the research preferences and experiences of children and adolescents with cancer to identify techniques for supporting this population as research participants. By incorporating developmentally appropriate, context-specific, and child-centered adjustments, researchers can help children and adolescents with cancer effectively and meaningfully describe their illness experiences while also developing a positive outlook on future research participation.
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Affiliation(s)
- Jessika Boles
- Child Life Services, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN 37232, USA.
| | - Sarah Daniels
- Child Life Program, St. Jude Children's Research Hospital, Memphis, TN 38163, USA
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