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Pediatric Sedation Outside of the Operating Room pp 397–412Cite as

Sedation for Pediatric Gastrointestinal Procedures

  • 1343 Accesses

Abstract

Providing sedation to ensure safe and successful performance of gastrointestinal endoscopy is fundamental to the diagnosis and treatment of digestive diseases of childhood. Nevertheless, no single sedative or combined sedation regimen has yet been established as ideal. General anesthesia and moderate sedation remain the two primary options for endoscopy in both children and adults. General anesthesia requires the presence and expertise of an anesthesiologist or certified registered nurse anesthetist and may involve inhalational or intravenous anesthetics. Moderate sedation, aimed at maintaining the child’s ability to breathe spontaneously with intact protective airway reflexes, almost always utilizes intravenous sedatives and may be administered by a physician or nurse, in the absence of an anesthesiologist. In general, either moderate sedation or anesthesia is necessary for children to remain comfortable and cooperative during gastrointestinal procedures. However, complications attributed to the sedation occur more commonly than do technical complications, such as bleeding or perforation, from endoscopy. Improving efficacy and safety for the sedation of gastrointestinal procedures has, in turn, been a topic of great interest among pediatric gastroenterologists (GI) since its inception in the 1970s.

Keywords

  • Pediatric
  • Sedation
  • Gastrointestinal (GI)
  • Endoscopy
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Endoscopic mucosal resection (EMR)
  • Submucosal dissection (ESD)
  • Magnetic resonance enterography (MRE)
  • Meperidine
  • Fentanyl
  • Diazepam
  • Midazolam
  • Reversal agents
  • Ketamine
  • Nitrous oxide
  • Propofol
  • Dexmedetomidine
  • Pulse oximetry
  • Precordial stethoscope
  • Capnography
  • North American Society of Pediatric Gastroenterology
  • Hepatology and Nutrition (NASPGHAN)
  • American Society of Anesthesiologists (ASA)
  • Body mass index (BMI)
  • Non-anesthesiologist-administered propofol sedation (NAAPS)
  • Nurse-administered propofol sedation (NAPS)
  • Bispectral index (BIS)
  • Patient-controlled sedation
  • American Society for Gastrointestinal Endoscopy (ASGE)
  • American Gastroenterological Association (AGA)
  • American College of Gastroenterology
  • Food and Drug Administration (FDA)
  • Computer-assisted personalized sedation (CAPS)

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  1. Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, UMass Memorial Children’s Medical Center, University of Massachusetts Medical School, Worcester, MA, USA

    Jenifer R. Lightdale

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    MD Keira P. Mason, MD

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Lightdale, J.R. (2021). Sedation for Pediatric Gastrointestinal Procedures. In: Mason, MD, K.P. (eds) Pediatric Sedation Outside of the Operating Room. Springer, Cham. https://doi.org/10.1007/978-3-030-58406-1_21

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