Sedation

Children may require sedation for procedures that adults are able to tolerate without sedation. Proper supervision and monitoring are essential for the safe provision of sedation to children whether they are under the care of anesthesiologists or other medical personnel.

The aim should be for conscious sedation. However, it is important to realize that the child may lapse into deep sedation once the stimulus of the procedure stops or if drug absorption is delayed. Because of the possibility of respiratory and cardiovascular depression with deeper levels of sedation, it is essential that the attending personnel are trained in life-support techniques and that full resuscitation equipment is immediately available. Pulse oximetry should be monitored as the minimum and should be continued until the child has recovered completely.

Children must be adequately assessed before receiving sedation and the fasting guidelines used for general anesthesia apply equally to patients undergoing sedation. The presence of a parent or carer can often give great comfort to a child undergoing medical procedures. Where procedures are expected to be painful, local anesthetics or analgesics, used as adjuncts, may reduce the necessity for increasing the level of sedation. Drugs commonly used in pediatric sedation include benzodiazepines, opioids, chloral hydrate, ketamine and trimeprazine.

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