Intravenous Sedation for Control of Distress during Lumbar Punctures for Pediatric Cancer Patients
Bibliographic record
Abstract
OBJECTIVE: To compare the sedative and amnestic effects, the rapidity of recovery, and the adverse effects of midazolam and propofol for intravenous sedation. The focus of this paper is the effects of intravenous sedation on distress, the acceptability to parents of this intervention for helping their children cope with painful procedures and the utility of an intravenous sedation program administered by an anesthetist. PATIENTS AND METHODS: Twenty six children were randomly assigned to intravenous sedation with either midazolam or propofol as the first drug received. Self‐report measures of anxiety and fear were assessed before and 30 min after the lumbar puncture (LP). Self‐report of pain was also assessed 30 min post‐LP. The children were videotaped during the LP, and the tapes were coded for pain and negative emotion using the Emotion Facial Action Coding System. One parent completed the acceptability questionnaire while the child was in the recovery room. RESULTS: Only three children indicated pain on the Visual Analogue Scale, and two children had facial expressions indicative of pain during the LP. Fear and anxiety differed as a function of procedure order, and children were more fearful and anxious before the first sedated LP than the second. Intravenous sedation was highly acceptable to parents, and neither drug was considered superior. CONCLUSIONS: Intravenous sedation with either propofol or midazolam, in combination with analgesia, was effective for alleviating pain and emotional distress associated with LPs. Although children were told that the sedation would make them relaxed and sleepy, they remained somewhat fearful until they experienced a comfortable LP. The benefits of an anesthetist‐administered intravenous sedation program are discussed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".