Indian Journal of Anaesthesia  
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Year : 2007  |  Volume : 51  |  Issue : 3  |  Page : 169-175

Paediatric procedural sedation - a review and an update

1 MD, DA, Professor, Department of Anaesthesia, Christian Medical College, Vellore, India
2 MD, DA, Jr Lecturer, Department of Anaesthesia, Christian Medical College, Vellore, India
3 MD, DA, Registrar, Department of Anaesthesia, Christian Medical College, Vellore, India

Correspondence Address:
Rebecca Jacob
Professor, Department Of Anaesthesia, Christian Medical College Hospital, Vellore-632004, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

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Sedation and analgesia are frequently administered to paediatric patients for procedures done outside the operating room. Both diagnostic and therapeutic procedures are now being increasingly done outside the oper­ating room partly due to time constraints, partly in an effort to decrease cost and partly due to fear of compli­cations of sedation. So children are often subjected to sedation by unskilled personnel with little or no training in resuscitation. In other cases children who would have benefited by sedation are being denied sedation and/ or left with long term psychological scars. The fear of undergoing a painful procedure or a procedure in unfamiliar surroundings remains considerably high. This is especially true in young children and mentally handicapped children. The whole issue is compounded by parental anxiety, separation from parents and pain or anticipation of pain during the procedure. It is poorly understood that procedures done outside the operat­ing room require the same attention to anxiolysis, analgesia, sedation and safety guidelines as procedures performed in the operating room. To this end we require appropriate definitions, goals, guidelines, monitoring and adequately trained personnel. In this review and update we have examined the international guidelines, looked at the drugs which may be used, and safety constraints. We also have enunciated guidelines for proce­dural sedation in children which may be adapted to the Indian scenario.

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