Procedure and Site-Specific Considerations for Pediatric Sedation

The appropriate management of anxiety and pain for diagnostic and therapeutic procedures in children frequently requires the administration of drugs with sedative properties. Sedation for these procedures has been associated with considerable risk for adverse events (1–3). In light of reports of lifethreatening adverse events, the American Academy of Pediatrics (AAP) (4), American Society of Anesthesiologists (ASA) (5), and Joint Commission on the Accreditation of Health Care Organizations (JCAHO) (6) have mandated guidelines in order to reduce continuing variability in practice, and the risk associated with sedation. These guidelines, as detailed in Chapter 2, emphasize the importance of uniformity of monitoring and care for sedated children, regardless of the nature of the procedure and the setting in which it is performed or the intended depth of sedation. Despite the availability of nationally publicized guidelines, there is great variability in sedation practice.