Conscious sedation: Reality or myth?

Pediatric patients often require sedation for procedures to decrease anxiety, improve cooperation, or provide pain relief. It is important to remember that conscious sedation, now termed moderate sedation and analgesia, is only one point in a continuum. During moderate sedation and analgesia, the patient is easily arousable to verbal or tactile (not painful) stimuli. It is essential to follow established guidelines for proper observation and monitoring of patients to ensure their safety and identify when they drift into deeper levels of sedation. Preparation and communication are important considerations for all children undergoing invasive or distressing procedures. The use of conscious sedation still requires the need to prepare the child and parents and to use communication and perhaps simple nonpharmacologic techniques to reduce child distress. When pharmacologic intervention is required, practitioners should be familiar with useful medications and follow the guidelines published by the AAP and the ASA.