(107) Evaluation of Procedural Sedation Outcomes with Dexmedetomidine for Lumbar punctures in Pediatric Oncology Patients

Poster Abstract:

Background: With 5-year survival rates exceeding 90% for pediatric acute lymphoblastic leukemia (ALL), there has a been a paradigm shift in research focusing on survivorship and long-term outcomes. Pediatric leukemia necessitates frequent lumbar punctures (LP) for diagnosis and treatment; with most patients receiving an average of 30 LPs over the course of their treatment. Propofol has long been used as the sedative of choice for these procedures, with majority of institution using some combination of propofol with an opioid and/or midazolam. However, repeated cumulative exposure to propofol during critical periods of brain development has been shown to cause neuronal apoptosis and neuroinflammation leading to a negative long-term effect on neurocognitive development in children. This study aims to ascertain the efficacy and safety of dexmedetomidine as a viable sedation option among pediatric oncology patients undergoing LPs.

Objectives: The primary objective of this study is to assess the feasibility of dexmedetomidine for procedural sedation in pediatric patients being treated for acute leukemia or lymphoma who will be undergoing an LP for diagnostic evaluation and/or intrathecal chemotherapy. Secondary objectives include procedural sedation outcomes.

Methods: A prospective, single-center observational study was conducted involving pediatric oncology patients (aged 1-18 years) with ALL or lymphoma undergoing sedation for an LP in the ambulatory setting. Patients with any known hypersensitivity to dexmedetomidine or patients required to have their LP done in any setting outside of the ambulatory care setting were excluded. Dexmedetomidine was administered intravenously following a standardized protocol. Outcomes measured sedation levels using a validated sedation scale, time to sedation, hemodynamic stability, respiratory parameters, sedation recovery time, and total dose of dexmedetomidine required.

Results: In process

Discussion/

Conclusions: In process

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