The Anesthesia-Directed Sedation Service: Models, Protocols, and Challenges

  • Joss Thomas


Anesthesiologists have made significant contributions to the specialty of pediatric sedation. In 1985, the first sedation guidelines were published by the American Academy of Pediatrics (AAP), with an anesthesiologist as the leading author. Although anesthesiologists may have led the pediatric sedation movements for the first two decades following this AAP publication, over the most recent decade, non-anesthesiologists have begun to replace anesthesiologists in some of the leading roles. In fact, anesthesia-directed sedation models may be on the decline. In 2005, only half of the respondents of a North American survey indicated that they had a formal sedation service. Only 26 % of institution-based sedation services involved either pediatric or general anesthesiologists.


Anesthesia-directed sedation service Anesthesia-directed sedation models Nurse-assisted propofol sedation (NAPS) Anesthesia physician assistants Anesthesiology assistants Sedation and anesthesia providers (SAP) Certified registered nurse anesthetist (CRNA) Objective risk assessment tool for sedation (ORATS) Computer-assisted personalized sedation (CAPS) Body mass index (BMI) American Academy of Pediatrics (AAP) American Society of Anesthesiologists (ASA) American College of Emergency Physicians (ACEP) American College of Gastroenterologists Monitored anesthesia care Joint Commission Texan Children’s Hospital Center for Medicare and Medicaid Services (CMS) Ketamine Pentobarbital Dexmedetomidine Propofol Food and Drug Administration (FDA) University of Iowa 


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Pediatric Anesthesia, Critical Care Medicine, Department of AnesthesiaUniversity of Iowa Children’s HospitalIowa CityUSA

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