02: Procedural Sedation Regimens Outside the Operating Room

Society for Pediatric Sedation (SPS) Podcast

In this episode, we will be welcoming Dr. Megan Peters and Dr. Abdallah Dalabih to have a chat with us about how to develop a sedation regimen for patients undergoing procedural sedation outside the operating room. Dr. Peters is the Assistant Professor of Pediatrics at the University of Wisconsin School of Medicine and Public Health. She is a pediatric intensivist and the Director of Pediatric Sedation Program at American Family Children’s Hospital. Dr. Dalabih is the Associate Professor of Pediatrics at the University of Arkansas for Medical Sciences and is also a pediatric intensivist.

He is the Director of Pediatric Sedation Programs at Arkansas Children’s Hospital. One of the hypothetical cases is where the patient is a three year old boy who needs an MRI with contrast for a prolonged focal seizure which occurred four days ago. He is previously healthy, has no significant past medical history and has not been exposed to anesthesia or procedural sedation in the past. He has no known drug allergies and on examination, his physical exam is unremarkable with normative vital signs for his age. He is also appropriately NPO. Stay tuned to learn more from Dr. Peters and Dr. Dalabih!

Show Highlights

• Factors to consider when creating a sedation regimen for a child who will undergo procedural sedation (01:18)
• Examples of painful, non-painful and distressing procedures (02:45)
• How to go about choosing a sedation regimen for patients in line with the guidelines of the American Academy of Pediatrics (05:22)
• Sedation for a child who has proven allergies such as anaphylaxis (06:55)
• Second hypothetical case: 5 year old girl with symptoms consistent with acute lymphocytic Leukemia and requires procedural sedation for a diagnostic bone marrow aspiration and biopsy with a lumbar puncture (10:09)
• Procedural sedation for a 6 year old girl who has autism spectrum disorder and requires procedural sedation in order to undergo venipuncture, ECD, and Echo (13:36)
• 9 year old with a distal radius and ulna fracture from a recent fall on his right arm requiring reduction and casting of the fracture (16:12)
• The importance of using a multidisciplinary team approach to sedation for (18:05)

Additional Resources

• Is Orally Administered Pentobarbital a Safe and Effective Alternative to Chloral Hydrate for Pediatric Procedural Sedation?