Pediatric sedation: Keeping your child calm during a procedure

Sometimes children need medical procedures that are long, uncomfortable or require them to stay still. Pediatric sedation uses medication to help your child relax and cooperate or fall asleep during a procedure.

A toddler-aged child at the end of the bed smiling in need of pediatric sedation

Pediatric sedation can help reduce a child’s stress during medical procedures.

“Sedation helps reduce your child’s stress during a medical experience, and it also makes it easier for your child’s care team to get the adequate imaging or perform the procedure efficiently,” said Dr. Edward Fernandez, pediatric intensivist with Marshfield Clinic Health System.

When is sedation used?

Different types of sedation can be used for procedures like placing an IV or catheter or drawing blood, along with procedures that lead to anxiety like CT or MRI imaging, ultrasounds or Echocardiogram. Sedation also is used for procedures like an esophagogastroduodenoscopy (EGD), which is placing a scope to look for a disease,” Dr. Fernandez said.

Your child’s care team will administer pediatric sedation. Sedatives can be given several ways, including:

Orally
Nasally
Inhaled
Injection
IV

Levels of sedation

Options for pediatric sedation are available based on your child’s age, medical history, developmental stage and the type of procedure. Pediatric sedation providers are skilled in identifying the safest, most appropriate type of sedation. There are three levels of sedation, including:

Mild sedation: Your child is awake but relaxed and less aware of the procedure. Typically, this is used for an IV, catheter, or drawing labs. This medication can be oral, nasal or inhaled.
Moderate sedation: Your child may be awake and relaxed or asleep but easy to wake. They may not remember the procedure after the medicine wears off. Typically, this is used for a CT, ultrasound or echocardiogram. This medication can be oral or IV.
Deep sedation: Your child will fall asleep after receiving sedation medication. They will not know what is happening during the procedure and will not remember it when the medicine wears off. Typically, this is used for a procedure that is either painful or needs to be still for like a MRI, interventional radiology procedure or an EGD. It is also used when the patient has disease conditions where any type of sedation could be problematic without a trained physician looking after the patient. The medication used for this is IV and needs to be given by a pediatric intensivist.

“Pediatric sedation is different from general anesthesia. Children will often recover quicker from sedation and can return to their usual activity,” Dr. Fernandez said. However, after sedation, children often are more tired than usual and not their normal selves.”

You will receive instructions on how to care for your child after sedation. You should plan to observe your child throughout the day and limit them to gentle activities.

Preparing for sedation

Oftentimes, your child will need to not eat or drink before sedation to have an empty stomach. Your care team will inform you about how long before the sedation your child will need to fast.

“Some children may feel nauseous or vomit during sedation, and it is essential in most types of sedation to have an empty stomach to avoid choking during the procedure,” Dr. Fernandez said.

What happens during sedation?

Once your child arrives for their appointment, they will be weighed and checked to make sure they are in good health for the sedation.

Sedation process will vary based on the type of sedation that is used. When the procedure is complete, your child may take 30-60 minutes to go back to their normal activities.

How you can help your child during sedation

Children often perceive your anxiety, which can make them more fearful. They will tolerate procedures best when you understand what to expect and prepare them for the experience. At Marshfield Clinic Health System, certified child life specialists play a crucial role in reducing the fear, anxiety and pain for children and their families.

If you have any questions about the sedation process, talk to your child’s provider. As you become more confident about the experience, so will your child.