Sedation in children – What to consider | Sedation

Sedation in children – What to consider

In children, sedation for diagnostic procedures, such as MRI, or short procedures is required more often than in adults. This is simply because children do not yet have an understanding of the need for an intervention and therefore do not keep still. Children have a different metabolism than adults depending on their age, so the dosage of sedating drugs cannot simply be calculated down to body weight.

Often small children need significantly higher doses to achieve the same effect as adults. Many sedating drugs are already approved for use in infancy. Some benzodiazepines can be administered not only via a venous route, but can also be given through the nasal mucosa or as suppositories, which already reduces children’s fear of sedation.

In all childhood sedation procedures it is important to ensure that a physician with experience in child intubation and venous access in children is present. The equipment in the various departments, such as radiology, must allow for emergency care of the child. More often than not, children have what are known as paradoxical reactions to benzodiazepines and become restless and anxious. In this case an alternative to sedation with benzodiazepines must be provided. All further information about anaesthesia in children can be found in the following article: Anaesthesia in children – process, risks, side effects

Sedation despite a cold?

A mild cold is not a contraindication for sedation. However, in case of febrile infections, medically unnecessary procedures should be postponed. In emergency cases, sedation is also possible during a febrile infection. In the case of a severe cold, the airways may be irritated and swollen, making emergency intubation difficult. However, this is still possible if procedures are necessary.

Sedation in pregnancy?

Some sedative drugs are placental and breast milk compatible. This means that the administration of the drugs does not only affect the mother but also the child. Benzodiazepines, the most commonly used sedatives, should be used in late pregnancy and lactation only when absolutely necessary, as they can cause breathing problems and weakness in the newborn baby’s drinking. Different medications are problematic at different times during pregnancy. In the last trimester, sedation with nitrous oxide may be used, as this has not shown any clinical damage to the child.