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Sedation in Pediatric Patients Undergoing Diagnostic Procedures

Sedation is routinely used in pediatric patients undergoing diagnostic procedures. Meperidine with promethazine and chlorpromazine; meperidine with pentobarbital; and meperidine, morphine, pentobarbital, thiopental, methohexital, chloral hydrate, and benzodiazepines as single agents have been used at different doses in patients for various procedures including computed tomography, endoscopy, electroencephalography, and bone marrow biopsies. Most available studies, however, have not compared these drugs in a controlled and blind manner, and the data have often been collected retrospectively. In addition, the degree and duration of sedation required may depend on the procedure. Thus, it is difficult to recommend the drug of choice for producing sedation. Serious cardiac and respiratory effects and excessive sedation have been associated with these drugs, even when normal doses were used. Controlled studies and specific guidelines are needed for optimal use and monitoring of these drugs in pediatric patients.