Which anesthetic drug is commonly used for short procedures on pediatric clients?

  • Couloures KG, Beach M, Cravero JP, Monroe KK, Hertzog JH. Impact of provider specialty on pediatric procedural sedation complication rates. Pediatrics. 2011;127(5):e1154–60. doi:10.1542/peds.2010-2960.

    CrossRef  PubMed  Google Scholar 

  • Coté CJ, Wilson S. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics. 2006;118(6):2587–602. doi:10.1542/peds.2006-2780.

    CrossRef  PubMed  Google Scholar 

  • Cravero JP, Beach ML, Blike GT, Gallagher SM, Hertzog JH. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesth Analg. 2009;108(3):795–804. doi:10.1213/ane.0b013e31818fc334.

    CrossRef  CAS  PubMed  Google Scholar 

  • Beach ML, Cohen DM, Gallagher SM, Cravero JP. Major adverse events and relationship to nil per Os status in pediatric sedation/anesthesia outside the operating room: a report of the pediatric sedation research consortium. Anesthesiology. 2016;124(1):80–88. doi: 10.1097/ALN.0000000000000933.

    CrossRef  CAS  Google Scholar 

  • Skolnick ET, Vomvolakis MA. A prospective evaluation of children with upper respiratory infections undergoing a standardized anesthetic and the incidence of adverse respiratory events. Anesthesiology. 1998;89:A1309.

    CrossRef  Google Scholar 

  • Tait AR, Shobha M, Voepel-Lewis T, Munro HM, Siewer M, Pandit UA. Risk factors for perioperative adverse respiratory events in children with upper respiratory tract infections. Anesthestiology. 2001;95(2):299–306.

    CrossRef  CAS  Google Scholar 

  • Aquilina AT, Hall WJ, Douglas Jr RG, Utell MJ. Airway reactivity in subjects with viral upper respiratory tract infections: the effects of exercise and cold air. Am Rev Respir Dis. 1980;122(1):3–10.

    CAS  PubMed  Google Scholar 

  • Ghofaily LA, Simmons C, Chen L, Liu R. Negative pressure pulmonary edema after Laryngospasm: a revist with a case report. J Anesth Clin Res. 2013;3(10):252.

    PubMed  PubMed Central  Google Scholar 

  • Raghavendran K, Nemzek J, Napolitano LM, Knight PR. Aspiration-induced lung injury. Crit Care Med. 2011;39(4):818–26.

    CrossRef  Google Scholar 

  • Hudgetl DW. Mechanisms of obstructive sleep apnea. Chest. 1992;101(2):541–9.

    CrossRef  Google Scholar 

  • Schwengel DA, Sterni LM, Tunkel DE, Heitmiller ES. Perioperative management of children with obstructive sleep apnea. Anesth Analg. 2009;109(1):60–75.

    CrossRef  Google Scholar 

  • de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, Sutton RM, Tijsse JA, Topjian A, van der Jagt EW, Schexnayder SM, Samson RA. Part 12: pediatric advanced life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2):S526–42.

    CrossRef  Google Scholar 

  • Malignant Hyperthermia Association of the United States. http://www.mhaus.org/healthcare-professionals/be-prepared/associated-conditions.

  • Glahn KP, Ellis FR, Halsall PJ, Muller CR, Snoeck MM, Urwyler A, Wappler F. Recognizing and managing a malignant hyperthermia crisis: guidelines from European Malignant Hyperthermia Group. Br J Anaesth. 2010;105(4):417–20.

    CrossRef  CAS  Google Scholar 

  • Hall SC, Santhanam S. Chapter 44. Neonatal anesthesia. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, editors. Clinical anesthesia. 6th ed. Lippincott Williams & Wilkins; Philadelphia: 2009. p. 1171–205.

    Google Scholar 

  • Kurth CD, Spitzer AR, Broennle AM, Downes JJ. Postoperative apnea in preterm infants. Anesthesiology. 1987;66:483.

    CrossRef  CAS  Google Scholar 

  • Justice LT, Valley RD, Bailey AG, Hauser M. Chapter 27. Anesthesia for ophthalmic surgery. In Davis PJ, Cladis FP, Motoyama EK, editors. Smith’s anesthesia for infants and children. 8th ed. 2011. p. 870–88. doi:10.1016/B978-0-323-06612-9.00044-4.

  • Martin T, Nicolson SC, Bargas MS. Propofol anesthesia reduces emesis and airway obstruction in pediatric outpatients. Anaesth Analg. 1993;76:144–8.

    CrossRef  CAS  Google Scholar 

  • Apfelbaum JL, Caplan RA, Connis RT, Epstein BS, Nickinovich DG, Warner MA. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Com. Anesthesiology. 2011;114(3):495–511. doi:10.1097/ALN.0b013e3181fcbfd9.

    CrossRef  Google Scholar 

  • Engelhardt T, Wilson G, Horne L, Weiss M, Schmitz A. Are you hungry? Are you thirsty?–fasting times in elective outpatient pediatric patients. Paediatr Anaesth. 2011;21(9):964–8. doi:10.1111/j.1460-9592.2011.03573.x.

    CrossRef  PubMed  Google Scholar 

  • Brady M, Kinn S, Ness V, O’Rourke K, Randhawa N, Stuart P. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev. 2009;(4):CD005285. doi:10.1002/14651858.CD005285.pub2.

  • Krauss B. Procedural sedation and analgesia in children. Lancet. 2006;367:766–80. doi:10.1016/S0733-8627(02)00084-6.

    CrossRef  CAS  PubMed  Google Scholar 

  • Cravero JP, Blike GT. Review of pediatric sedation. Anesth Analg. 2004;99(5):1355–64.

    CrossRef  Google Scholar 

  • Tobias JD. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med. 2007;8(2):115–31.

    CrossRef  Google Scholar 

  • Duma A, Cartmill C, Blood J, Sharma A, Kharasch ED, Nagele P. The hematological effects of nitrous oxide anesthesia in pediatric patients. Anesth Analg. 2015;120(6):1325–30.

    CrossRef  CAS  Google Scholar 

  • Patel RI, Davis PJ, Orr RJ, Ferrari LR, Rimar S, Hannallah RS, Cohen IT, Colingo K, Donlon JV, Haberkern CM, McGowan FX, Prillaman BA, Parasuraman TV, Creed MR. Single-dose Ondansetron prevents postoperative vomiting in pediatric outpatients. Anesth Analg. 1997;85:538–45.

    CrossRef  CAS  Google Scholar 

  • Lim E, Rai E, Seow WT. Feasibility of anaesthetic provision for paediatric patients undergoing off-site intraoperative MRI-guided neurosurgery: the Singapore experience from 2009 to 2012. Anaesth Intensive Care. 2013;41(4):535–42. http://www.ncbi.nlm.nih.gov/pubmed/23808515. Accessed 3 Nov 2015.

    CAS  PubMed  Google Scholar 

  • Apfelbaum JL, Singleton MA, Ehrenwerth J, Bell C, Connis RT, Mason KP, McClain CD, Nickinovich DG, Sandberg WS. Practice advisory on anesthetic care for magnetic resonance imaging. An updated report by the American Society of Anesthesiologists Task Force on anesthetic care for magnetic resonance imaging. Anesthesiology. 2015;122:495–520.

    CrossRef  Google Scholar 

  • Campbell K, Torres L, Stayer S. Anesthesia and sedation outside the operating room. Anesthesiol Clin. 2014;32(1):25–43. doi:10.1016/j.anclin.2013.10.010.

    CrossRef  PubMed  Google Scholar 

  • Thorp N. Basic principles of paediatric radiotherapy. Clin Oncol. 2013;25(1):3–10. doi:10.1016/j.clon.2012.08.006.

    CrossRef  CAS  Google Scholar 

  • Merchant TE, Farr JB. Proton beam therapy. Curr Opin Pediatr. 2014;26(1):3–8. doi:10.1097/MOP.0000000000000048.

    CrossRef  CAS  PubMed  Google Scholar 

  • Scott L, Langton F, O’Donoghue J. Minimising the use of sedation/anaesthesia in young children receiving radiotherapy through an effective play preparation programme. Eur J Oncol Nurs Off J Eur Oncol Nurs Soc. 2002;6(1):15–22. doi:10.1054/ejon.2001.0162.

    CrossRef  Google Scholar 

  • Fortney JT, Halperin EC, Hertz CM, Schulman SR. Anesthesia for pediatric external beam radiation therapy. Int J Radiat Oncol Biol Phys. 1999;44(3):587–91.

    CrossRef  CAS  Google Scholar 

  • Saito T, Kaneko A, Muramatsu Y, et al. Difficult tracheal intubation in patients with retinoblastoma caused by 13q deficiency. Jpn J Clin Oncol. 1998;28(8):507–10. doi:10.1093/jjco/28.8.507.

    CrossRef  CAS  PubMed  Google Scholar 

  • Whyte SD, Mark AJ. Anesthetic considerations in the management of Wilms’ tumor. Paediatr Anaesth. 2006;16(5):504–13. doi:10.1111/j.1460-9592.2006.01866.x.

    CrossRef  PubMed  Google Scholar 

  • Latham GJ, Greenberg RS. Anesthetic considerations for the pediatric oncology patient – part 3: pain, cognitive dysfunction, and preoperative evaluation. Paediatr Anaesth. 2010;20(6):479–89. doi:10.1111/j.1460-9592.2010.03261.x.

    CrossRef  PubMed  Google Scholar 

  • Evans P, Chisholm D. Anaesthesia and paediatric oncology. Curr Anaesth Crit Care. 2008;19(2):50–8. doi:10.1016/j.cacc.2007.07.012.

    CrossRef  Google Scholar 

  • Buchsbaum JC, McMullen KP, Douglas JG, et al. Repetitive pediatric anesthesia in a non-hospital setting. Int J Radiat Oncol Biol Phys. 2013;85(5):1296–300. doi:10.1016/j.ijrobp.2012.10.006.

    CrossRef  PubMed  Google Scholar 

  • Anghelescu DL, Burgoyne LL, Liu W, et al. Safe anesthesia for radiotherapy in pediatric oncology: St. Jude Children’s Research Hospital Experience, 2004–2006. Int J Radiat Oncol Biol Phys. 2008;71(2):491–7. doi:10.1016/j.ijrobp.2007.09.044.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Dagal A. Radiation safety for anesthesiologists. Curr Opin Anaesthesiol. 2011;24(4):445–50. doi:10.1097/ACO.0b013e328347f984.

    CrossRef  Google Scholar 

  • Iravani M. Pediatric malignancies and anesthesia in out-of-or locations. Int Anesthesiol Clin. 2009;47(3):25–33. doi:10.1097/AIA.0b013e3181ab1271.

    CrossRef  PubMed  Google Scholar 

  • Pitetti RD, Singh S, Pierce MC. Safe and efficacious use of procedural sedation and analgesia by nonanesthesiologists in a pediatric emergency department. Arch Pediatr Adolesc Med. 2003;157(11):1090. doi:10.1001/archpedi.157.11.1090.

    CrossRef  PubMed  Google Scholar 

  • Shavit I, Hershman E. Management of children undergoing painful procedures in the emergency department by non-anesthesiologists. Israel Med Assoc J IMAJ. 2004;6(6):350–5. http://www.ncbi.nlm.nih.gov/pubmed/15214463.

    Google Scholar 

  • Migita RT, Klein EJ, Garrison MM. Sedation and analgesia for pediatric fracture reduction in the emergency department. Arch Pediatr Adolesc Med. 2006;160(1):46. doi:10.1001/archpedi.160.1.46.

    CrossRef  PubMed  Google Scholar 

  • Kennedy RM, Luhmann JD, Luhmann SJ. Emergency department management of pain and anxiety related to orthopedic fracture care: a guide to analgesic techniques and procedural sedation in children. Paediatr Drugs. 2004;6(1):11–31. http://www.ncbi.nlm.nih.gov/pubmed/14969567. Accessed 15 Oct 2015.

    CrossRef  Google Scholar 

  • Roback MG, Wathen JE, Bajaj L, Bothner JP. Adverse events associated with procedural sedation and analgesia in a pediatric emergency department: a comparison of common parenteral drugs. Acad Emerg Med Off J Soc Acad Emerg Med. 2005;12(6):508–13. doi:10.1197/j.aem.2004.12.009.

    CrossRef  Google Scholar 

  • Kennedy RM, Porter FL, Miller JP, Jaffe DM. Comparison of fentanyl/midazolam with ketamine/midazolam for pediatric orthopedic emergencies. Pediatrics. 1998;102(4 Pt 1):956–63. http://www.ncbi.nlm.nih.gov/pubmed/9755272. Accessed 15 Oct 2015.

    CrossRef  CAS  Google Scholar 

  • Lamond DW. Review article: safety profile of propofol for paediatric procedural sedation in the emergency department. Emerg Med Australas. 2010;22(4):265–86. doi:10.1111/j.1742-6723.2010.01298.x.

    CrossRef  PubMed  Google Scholar 

  • Mallory MD, Baxter AL, Yanosky DJ, Cravero JP. Emergency physician-administered propofol sedation: a report on 25,433 sedations from the pediatric sedation research consortium. Ann Emerg Med. 2011;57(5):462–468.e1. doi:10.1016/j.annemergmed.2011.03.008.

    CrossRef  PubMed  Google Scholar 

  • Lai YH, Hsu HT, Wang HZ, Cheng KI, Wu KY. The oculocardiac reflex during stabismus surgery: its relationship to preoperative clinical eye findings and subsequent postoperative emesis. J AAPOS. 2014;18(2):151–5.

    CrossRef  Google Scholar 

  • Sbaraglia F, Mores N, Garra R, Giuratrabocchetta G, Lepore D, Molle F, Savino G, Piastra M, Pulitano S, Sammartino M. Phenylephrine eye drops in pediatric patients undergoing ophthalmic surgery: incidence, presentation, and management of complications during general anesthesia. Paediatr Anaesth. 2014;24(4):400–5.

    CrossRef  Google Scholar 

  • McGoldrick KE. Complications of regional anesthesia for ophthalmic surgery. Yale J Biol Med. 1993;66(5):443–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Mason KP, Holzman RS. Chapter 33. Anesthesia and sedation for pediatric procedures outside the operating room. In: Davis PJ, Cladis FP, Motoyama EK, editors. Smith’s anesthesia for infants and children. 8th ed. 2011. p. 1041–57. doi:10.1016/B978-0-323-06612-9.00044-4.

  • Squires R, Morriss F, Schluterman S, Drews B, Galyen L, Brown KO. Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures. Gastrointest Endosc. 1995;41(2):99–104.

    CrossRef  Google Scholar 

  • Koh JL, Black DD, LEatherman IK, Harrison RD, Schmitz ML. Experience with an anesthesiologist interventional model for endoscopy in a pediatric hospital. J Pediatr Gastroenterol Nutr. 2001;33:314–8.

    CrossRef  CAS  Google Scholar 

  • Thakkar K, El-Serang HB, Mattek N, Gilger MA. Complications of pediatric EGD: a 4-year experience in PEDS-CORI. Gastrointest Endosc. 2007;65(2):213–21.

    CrossRef  Google Scholar 

  • Stiles CM. Anesthesia for the mentally retarded patient. Orthop Clin North Am. 1981;12(1):45–56. http://www.ncbi.nlm.nih.gov/pubmed/7207992. Accessed 2 Nov 2015.

    CAS  PubMed  Google Scholar 

  • Macpherson A. Sevoflurane or halothane could be used for intellectually disabled children under day-stay general anaesthesia. Evid Based Dent. 2006;7(2):37. doi:10.1038/sj.ebd.6400408.

    CrossRef  PubMed  Google Scholar 

  • Miyawaki T, Kohjitani A, Maeda S, et al. Intravenous sedation for dental patients with intellectual disability. J Intellect Disabil Res JIDR. 2004;48(Pt 8):764–8. doi:10.1111/j.1365-2788.2004.00598.x.

    CrossRef  CAS  PubMed  Google Scholar 

  • Kannikeswaran N, Mahajan PV, Sethuraman U, Groebe A, Chen X. Sedation medication received and adverse events related to sedation for brain MRI in children with and without developmental disabilities. Paediatr Anaesth. 2009;19(3):250–6. doi:10.1111/j.1460-9592.2008.02900.x.

    CrossRef  PubMed  Google Scholar 

  • Enever GR, Nunn JH, Sheehan JK. A comparison of post-operative morbidity following outpatient dental care under general anaesthesia in paediatric patients with and without disabilities. Int J Paediatr Dent/British Paedodont Soc Int Assoc Dent Child. 2000;10(2):120–5. http://www.ncbi.nlm.nih.gov/pubmed/11310096. Accessed 2 Nov 2015.

    CrossRef  Google Scholar 

  • Böhmer C, Niezen-de Boer M, Klinkenberg-Knol E, Nadorp J, Meuwissen S. Gastro-oesophageal reflux disease in institutionalised intellectually disabled individuals. Neth J Med. 1997;51(4):134–9. http://www.ncbi.nlm.nih.gov/pubmed/9643224.

    CrossRef  Google Scholar 

  • Kilbaugh TJ, Friess SH, Raghupathi R, Huh JW. Sedation and analgesia in children with developmental disabilities and neurologic disorders. Int J Pediatr. 2010;2010. doi:10.1155/2010/189142.

    CrossRef  Google Scholar 

  • Xue FS, Zhang YM, Liao X, Luo MP. Anesthesia and airway management for children with tonsillar hypertrophy. Paediatr Anaesth. 2009;19(6):642–3. doi:10.1111/j.1460-9592.2009.02950.x.

    CrossRef  PubMed  Google Scholar 

  • Nakazawa K, Ikeda D, Ishikawa S, Makita K. A case of difficult airway due to lingual tonsillar hypertrophy in a patient with Down’s syndrome. Anesth Analg. 2003;97(3):704–5. http://www.ncbi.nlm.nih.gov/pubmed/12933389. Accessed 2 Nov 2015.

    CrossRef  Google Scholar 

  • Schiff J-H, Russ N, Ihringer K, Heal C, Martin E, Walther A. Pediatric patients with disabilities – assessment of satisfaction with anesthesia. Paediatr Anaesth. 2012;22(11):1117–23. doi:10.1111/j.1460-9592.2012.03886.x.

    CrossRef  PubMed  Google Scholar 

  • Borland LM, Colligan J, Brandom BW. Frequency of anesthesia-related complications in children with Down syndrome under general anesthesia for noncardiac procedures. Paediatr Anaesth. 2004;14(9):733–8. doi:10.1111/j.1460-9592.2004.01329.x.

    CrossRef  PubMed  Google Scholar 

  • (NDSS) NDSS. National Down Syndrome Society. http://www.ndss.org/Resources/Health-Care/Associated-Conditions/Anesthesia-Down-Syndrome/#sthash.dcmRGqA0.dpuf.

  • Steward DJ. Anesthesia considerations in children with Down syndrome. Semin Anesth Perioperat Med Pain. 2006;25(3):136–41. doi:10.1053/j.sane.2006.05.001.

    CrossRef  Google Scholar 

  • Hata T, Todd MM. Cervical spine considerations when anesthetizing patients with Down syndrome. Anesthesiology. 2005;102(3):680–5. http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1942107. Accessed 3 Nov 2015.

    CrossRef  Google Scholar 

  • Matisoff AJ, Olivieri L, Schwartz JM, Deutsch N. Risk assessment and anesthetic management of patients with Williams syndrome: a comprehensive review. Paediatr Anaesth. 2015;25(12):1207–15. doi:10.1111/pan.12775.

    CrossRef  PubMed  Google Scholar 

  • Buget MI, Canbolat N, Akgul T, Kucukay S. Anaesthesia and orphan disease: anaesthetic management of a child with Hamamy syndrome. Eur J Anaesthesiol. 2015;32(12):891–3. doi:10.1097/EJA.0000000000000263.

    CrossRef  PubMed  Google Scholar 

  • Kulkarni P, Shah R, Priyanka VN. Anesthetic management in a child with Job’s syndrome. Anesth Essays Res. 2012;6(2):223–5. doi:10.4103/0259-1162.108342.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Geze S, Arslan U, Tusat M. Anaesthesia for infant with Jarcho Levin syndrome: case report. Braz J Anesthesiol (Elsevier). 2015;65(5):414–6. doi:10.1016/j.bjane.2012.12.005.

    CrossRef  Google Scholar 

  • Manyande A, Cyna AM, Yip P, Chooi C, Middleton P. Non-pharmacological interventions for assisting the induction of anaesthesia in children. Cochrane Database Syst Rev. 2015;7:CD006447. doi:10.1002/14651858.CD006447.pub3.

  • Which anesthetic medication is commonly used for short procedures on pediatric clients?

    Propofol is a short acting hypnotic agent that can be given in low doses to achieve short acting and controlled sedation.

    What is the most common sedative drug used for pediatric?

    Pentobarbital: Most Frequently Used Barbiturate for Pediatric Sedation.

    What is the agent of choice for Paediatric Anaesthesia?

    Midazolam. Midazolam is a water-soluble benzodiazepine and the most commonly used sedative premedicant in children. The benefits include a rapid and reliable onset and antegrade amnesia with minimal respiratory depression.

    What is the most common anesthesia drug?

    Propofol (Diprivan®) is the most commonly used IV general anesthetic. In lower doses, it induces sleep while allowing a patient to continue breathing on their own. It is often utilized by anesthesiologist for sedation in addition to anxiolytics and analgesics.