Sedation and analgesia in paediatric care

As a rule the indication for sedation should be broad. Any child who is, or could be, frightened by an intervention should have the benefit of sedatio n. Correspondingly, an analgesic should be chosen if the intervention is pa inful. The sedatives of choice are midazolam and chloral hydrate, and possi bly a neuroleptic for interventions which require the child to be motionles s. Any physician who sedates a child must be aware of the side effects of t he sedation and be well versed in countermeasures, including resuscitation. The dangers of sedation arise from wrong selection of patients and also fr om postsedation and combination of sedatives and analgesics; both should be left to experienced physicians or specialists. If sedation or analgesia is planned with the rest of the intervention and the described guidelines are followed, the patient's safety is ensured. Despite all efforts a small pro portion of patients show an inadequate response to the chosen medication. I n young children and in sick children the specific physiological and anatom ical features will overtax the therapist. In such cases the help and advice of a specialist trained in paediatric anaesthesia can and should be sought .