[Sedation and analgesia in childhood].
As a rule the indication for sedation should be broad. Any child who is, or could be, frightened by an intervention should have the benefit of sedation. Correspondingly, an analgesic should be chosen if the intervention is painful. The sedatives of choice are midazolam and chloral hydrate, and possibly a neuroleptic for interventions which require the child to be motionless. Any physician who sedates a child must be aware of the side effects of the sedation and be well versed in countermeasures, including resuscitation. The dangers of sedation arise from wrong selection of patients and also from postsedation and combination of sedatives and analgesics; both should be left to experienced physicians or specialists. If sedation or analgesia is planned with the rest of the intervention and the described guidelines are followed, the patient's safety is ensured. Despite all efforts a small proportion of patients show an inadequate response to the chosen medication. In young children and in sick children the specific physiological and anatomical features will overtax the therapist. In such cases the help and advice of a specialist trained in paediatric anaesthesia can and should be sought.
Schwarz
U
U
Anästhesie-Abteilung, Universitäts-Kinderklinik Zürich. u.schwarz@switzerland.org
Bänziger
O
O
Gerber
A
A
D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D016292:Procedural Sedation / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008991:Monitoring, Physiologic
D000700:Analgesics; D006993:Hypnotics and Sedatives