Is more sedating
Procedural sedation may be defined as the administration of sedative or dissociative agents, with or without analgesics, to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function.
Sedation is stimulus-dependent; accordingly, when the procedure is completed, the child is likely to become more sedated than during the procedure, which can lead to hypoventilation and hypoxia.Until comparatively recently, children too young to verbalize were also considered too young to experience pain or fear, and they often received no analgesia, even after major surgery.However, it is now known that even neonates show a physiologic response to painful stimuli.The function of sedation is management of anxiety, pain, and control of excessive motion.Diagnostic procedures for which emergency department (ED) sedation may be indicated include the following: Discussion about the risks, benefits, and alternatives with the parent or guardian is necessary before initiation of procedural sedation.Reasons for inadequate treatment include failure to recognize pain, ignorance about drugs and dosages, fear of adverse cardiovascular effects, and fear of delay in treatment and disposition. Conscious sedation (in which the patient remains awake) may lead to deep sedation.Deep sedation, in turn, may lead to general anesthesia, which may lead to cardiorespiratory compromise and loss of airway protective reflexes. What is more, the health care providers who practice pediatric sedation come from several different fields, including emergency medicine, anesthesiology, intensive care medicine, and radiology.In addition, research has shown that children often do not receive the same treatment as adults with similar painful conditions.Age is apparently a risk factor for oligoanalgesia.Unfortunately, the current practice of many EDs is not standardized.Many centers and practitioners do not use premedication for children undergoing painful procedures.