• Chihiro Sekijima, Reika Akutsu, Mamiko Sato, Izumi Hamaya, and Norifumi Kuratani.
• Department of Anesthesia, Saitama Children's Medical Center, Saitama 339-8551.
• Masui. 2013 Sep 1; 62 (9): 1053-9.

AbstractProcedural sedation and analgesia comprise an integral part of high quality tertiary care in pediatrics. All patients undergoing procedural sedation should be evaluated as extensively as in patients receiving general anesthesia, and an appropriate fasting time should also be considered. Since cardio-respiratory side effects are inevitably associated with sedative medications, (1) only medical personnel with an expertise in the use of these medications should manage procedural sedation, and (2) additionally, the choice of medication should be decided on a case-by-case basis as no single sedation recipe has proven superior to others. Analgesics should be introduced during painful procedures in order to reduce the chance of overdose by hypnotics alone. During sedation, medical staff should continuously monitor the patients so that prompt resuscitation can be provided if unexpected critical events occur. Following the procedure, medical staff should also monitor patients until full recovery is achieved. Pediatric anesthesiologists should be involved in the sedation procedure for patients with complicated medical histories. Finally, care should be taken to avoid ferrous equipment when performing sedation in an MRI suite.

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