Sedation

Chapter

Abstract

Gastrointestinal endoscopic procedures are the most important diagnostic and therapeutic tools in pediatric gastroenterology. In order to avoid pain and ensure safety, the endoscopy is performed in most of the cases under sedation or general anesthesia. Protocols may include use of different molecules with combined analgesic effects. Even though it is preferable to perform sedation by anesthesiologist, many recent data support the sedation by non-anesthesiologist as personnel with specialized and appropriate training.

Keywords

Gastrointestinal endoscopy Sedatives Anesthetics Pediatrics 

References

  1. 1.
    ASGE Standards of Practice Committee, Lightdale JR, Acosta R, Shergill AK, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2014;79:699–710.CrossRefGoogle Scholar
  2. 2.
    Ramaiah R, Bhananker S. Pediatric procedural sedation and analgesia outside the operating room: anticipating, avoiding and managing complications. Expert Rev Neurother. 2011;11:755–63.CrossRefGoogle Scholar
  3. 3.
    van Beek EJ, Leroy PL. Safe and effective procedural sedation for gastrointestinal endoscopy in children. J Pediatr Gastroenterol Nutr. 2012;54:171–85.CrossRefGoogle Scholar
  4. 4.
    Faigel DO, Baron TH, Goldstein JL, et al. Guidelines for the use of deep sedation and anesthesia for GI endoscopy. Gastrointest Endosc. 2002;56:613–7.CrossRefGoogle Scholar
  5. 5.
    Orel R, Brecelj J, Dias JA, et al. Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists. World J Gastrointest Endosc. 2015;7:895–911.CrossRefGoogle Scholar
  6. 6.
    Cote CJ, Wilson S. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics. 2006;118:2587–602.CrossRefGoogle Scholar
  7. 7.
    Hoffman GM, Nowakowski R, Troshynski TJ, et al. Risk reduction in pediatric procedural sedation by application of an American Academy of Pediatrics/American Society of Anesthesiologists process model. Pediatrics. 2002;109:236–43.CrossRefGoogle Scholar
  8. 8.
    Cravero JP, Beach ML, Blike GT, et al. Pediatric Sedation Research Consortium. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesth Analg. 2009;108:795–804.CrossRefGoogle Scholar
  9. 9.
    Sahyoun C, Krauss B. Clinical implications of pharmacokinetics and pharmacodynamics of procedural sedation agents in children. Curr Opin Pediatr. 2012;24:225–32.CrossRefGoogle Scholar
  10. 10.
    Shah PS, Shah VS. Propofol for procedural sedation/anaesthesia in neonates. Cochrane Database Syst Rev. 2011;3:CD007248.Google Scholar
  11. 11.
    Brecelj J, Trop TK, Orel R. Ketamine with and without midazolam for gastrointestinal endoscopies in children. J Pediatr Gastroenterol Nutr. 2012;54:748–52.CrossRefGoogle Scholar
  12. 12.
    Heinz P, Geelhoed GC, Wee C, Pascoe EM. Is atropine needed with ketamine sedation? A prospective, randomised, double blind study. Emerg Med J. 2006;23:206–9.CrossRefGoogle Scholar
  13. 13.
    Langston WT, Wathen JE, Roback MG, Bajaj L. Effect of ondansetron on the incidence of vomiting associated with ketamine sedation in children: a double-blind, randomized, placebo-controlled trial. Ann Emerg Med. 2008;52:30–4.CrossRefGoogle Scholar
  14. 14.
    Cohen LB, Wecsler JS, Gaetano JN, et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol. 2006;101:967–74.CrossRefGoogle Scholar
  15. 15.
    Montes RG, Bohn RA. Deep sedation with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy. J Pediatr Gastroenterol Nutr. 2000;31:41–6.CrossRefGoogle Scholar
  16. 16.
    Michaud L, Gottrand F, Ganga-Zandzou PS, et al. Nitrous oxide sedation in pediatric patients undergoing gastrointestinal endoscopy. J Pediatr Gastroenterol Nutr. 1999;28:310–4.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”University of MessinaMessinaItaly

Personalised recommendations