Assessing Patient State and Efficacy

Pediatric procedural sedation is required for a wide variety of interventions ranging from nonstimulating imaging procedures to painful minor surgeries and other tests. The measurement of how well a given sedation strategy has met the requirements for a procedure is not well codified by simply noting the depth of sedation provided. Patients may be deeply sedated but thrashing about during a painful procedure, and they may be almost awake and perfectly tolerating a minor procedure. Procedural sedation must be measured using a rubric that appreciates the “state” of the patient and qualifies his or her movement, stress, pain, and safety at any specific time point during the procedure. The ability to control these factors and provide an acceptable state for the patient and the proceduralist should be the standard for measuring the quality of sedation provision for children.