This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Two different sedative regimens for diagnostic and therapeutic lumbar punctures conducted on children with cancer are being studied for safety and efficacy purposes. Children with acute leukemia undergo at least 10 invasive procedures per year for their cancer treatment. Research has shown that procedural pain control in children with cancer is one of the most important aspects of their cancer treatment. Indeed, studies have shown that poorly controlled procedural pain in children with cancer is associated with the development of depression and anxiety disorders. Also, poor procedural pain control leads to more difficulty in controlling pain for future procedures. Consequently, the American Academy of Pediatrics has recommended that aggressive procedural pain control in children with cancer be an integral part of cancer treatment. Our study's primary purpose is to find which of two sedative regimens is safest for a child with cancer undergoing lumbar puncture procedures. Children will be monitored for their oxygen levels, blood pressure and heart rate. Our plan is to study 40 children with acute leukemia or lymphoma. Each child is studied twice in a randomized manner so that the safety and efficacy of each sedative regimen is evaluated once. At the end of the study period, the safety and efficacy profiles of each regimen are evaluated. If both regimens are equally safe, families and children can choose which regimen they would prefer for future invasive procedures.
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