Procedural sedation 2010

The demand of diagnostic and therapeutic procedures performed on children outside of the operating room and the intensive care unit has increased substantially in recent years. At the same time the management of acute pain and emotional distress related to such procedures has become a primary goal for paediatricians. The availability of non-invasive monitoring, short-acting opioids and sedatives has broadened in different settings the possibilities of sedation and analgesia practiced by non anaesthesiologists. An appropriate management of sedation is important in order to avoid adding further risks to normal procedures. A standard approach is mandatory to provide safety and efficiency. This paper reviews the different aspects of sedation and analgesia performed by paediatricians for invasive and non-invasive procedures, as patients' selection and assessment, specific personnel training, monitoring tools and the prevention of potential complications.