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To obtain high-quality CT and MRI scans, children may need to stay immobile in a particularly uncomfortable environment for a reasonable length of time. Although young infants may sleep after a feed and older children can be accommodating, many infants and children are not cooperative. The use of sedation or anaesthetics in children to provide a sleep-induced state and reduce anxiety is therefore often necessary for successful radiological practice.
As anaesthetic resources and suitable equipment may be limited in some paediatric departments, many drugs have become used in children to provide safe and effective sedation. Within the UK, the only licensed drugs for sedation during radiological procedures in children are midazolam by intravenous, intramuscular or rectal routes and oral temazepam. There is also no uniform practice or guidelines regarding which pharmacological agent to use within the UK; however, the National Institute for Clinical Excellence is in the process of producing guidelines in 2010. This review aimed to provide the most up-to-date evidence about the medicines used for paediatric sedation including some used outside the UK, focusing on their success rates and the adverse reactions associated with them. Medicines, however, only form part of the picture for sedation; a whole systems approach is needed. This needs to include assessment, selection and preparation of patients before the procedure. The training and the competencies of the staff need to be maintained, and regular audit of practice should take place. Sedation sparing techniques should be used whenever possible.1
Levels of sedation
Sedation causes decreased consciousness, anxiolysis and amnesia and therefore is defined as a continuum from wakefulness to anaesthesia. Table 1 shows the definitions provided by the American Society of Anesthesiologists for levels of sedation.2
To ensure safe practice in children having …
Competing interests None.
Provenance and peer review Commissioned; externally peer reviewed.