Pediatric Sedation

The processes of care involved in providing sedation and analgesia for children undergoing diagnostic and therapeutic procedures have evolved from an afterthought necessary to accomplish a procedure humanely to almost a medical discipline of its own centering around patient physical and psychological comfort and safety. Many of the tests and procedures common to modern medical care are easily accomplished for a competent adult who is able to understand the advantages of holding still, the timeframe of brief painful injections, and the future benefits represented by accomplishing the unpleasant test. Infants and children developmentally cannot project such abstract thinking to rationalize an unpleasant experience and may experience potentially long-lasting psychological consequences unless healthcare professionals provide supportive and preventive care. In this sense, procedural sedation is a uniquely pediatric field. This chapter should serve to place the rapidly emerging arena of pediatric procedural sedation into an appropriate historical context from which the reader may better understand the current state of the art of pediatric sedation and recognize the gaps in understanding of best practice in the complex care required.