Sedation
There are two main areas where
sedation is required—during procedures and whilst receiving paediatric
intensive care.
There are many sedative agents
available. All sedative agents decrease conscious level and, thereby, can have
significant toxicity. The choice of sedative agent depends upon local
experience and how quickly and for how long sedation is needed. If a child is
likely to be difficult to sedate, then consider whether a short-acting general
anaesthetic, administered by a paediatric anaesthetist, is safer and kinder to
the child.
The purpose of sedation in the
paediatric intensive care unit (PICU) is to help the child not the health
professional. IV midazolam is the drug of choice on admission. Subsequently,
once NG feeds are tolerated, chloral hydrate and promethazine have been shown
to be more effective than midazolam. Propofol is contraindicated for use in the
PICU, with the exception for procedures, in view of the risk of a fatal ADR.
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