Sedation/Analgesia for diagnostic and therapeutic procedures in children.
Sedation/analgesia for diagnostic and therapeutic procedures in children has been associated with life-threatening adverse events. Reports of adverse events and recognition of wide variability in sedation practices has led to the development of guidelines and standards of care to ensure the safety of sedated children. The safety of sedated children can be enhanced by detailed presedation evaluation, careful patient selection, and the use of drugs with a wide margin of safety that are carefully titrated to desired depth of sedation by trained personnel. Once sedative drugs are administered, stringent monitoring, including continuous pulse oximetry and frequent assessment of vital signs and sedation depth, will permit early recognition of untoward drug effects and permit early intervention. Children with underlying medical conditions, such as airway abnormalities, may not be suitable subjects for sedation and may require consideration for general anesthesia to aid their procedure. Although significant strides have been made in recognition of the risks of sedation and in development of guidelinesfor safe sedation practices, further work must focus on development of newer sedation regimens with shorter-acting drugs and wider margins of safety.
Malviya
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University of Michigan Medical Center, C.S. Mott Children's Hospital, Ann Arbor 48109-0211, USA.
Voepel-Lewis
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Tait
A R
AR
Merkel
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S
D000698:Analgesia / Q000379:methods / Q000451:nursing*; D002648:Child; D016292:Procedural Sedation / Q000379:methods / Q000451:nursing*; D006801:Humans; D010371:Pediatric Nursing / Q000379:methods*; D013527:Perioperative Nursing / Q000379:methods*