Sedation of the pediatric and adolescent patient for GI procedures

Abstract

There remains no ideal sedative for pediatric and adolescent patients undergoing gastrointestinal procedures. Instead, pediatric gastroenterologists must consider many factors, including patient age, medical history, clinical status, anxiety level, as well as targeted sedation level, to select the appropriate methods and agents to achieve optimal sedation for endoscopy. The two primary types of sedation are endoscopist-administered intravenous (IV) sedation and anesthesiologist-administered general anesthesia. If IV sedation is used, pediatric endoscopists must be prepared for children to become agitated, adding to stress for both patients and clinical staff. General anesthesia provides the advantage of complete patient immobility but also entails increased costs and utilization of hospital resources. Technical advances in electronic monitoring, both in the pediatric endoscopy suite and operating room settings, are contributing to increased patient safety. Nevertheless, sedation-related events, independent of type of sedation or regimen, represent the most common complications of pediatric endoscopy.