Paediatric Sedation

Question 1

Indications for paeds IS?

Answer 1

Has to be happy to understand concept of nasal breathing and not be a mouth breather - of an age and of a maturity

Mild to moderate anxiety levels - good for needle phobia

Good for management of children with pronounced gag reflex

Good for children with medical conditions where anxiety can worsen, etc asthma

Previous positive experiences

Question 2

Contraindications of IS in paeds?

Answer 2

Child cannot understand concept of IS and requirement of breathing through nose

Of a mature age with proper understanding - around 5/6 ish

Extreme anxiety

MH - learning difficulties or mentally impaired, nasal blockage, mouth breather, claustrophobic, severe psychiatric disorder, pregnancy

Previous unsuccessful inhalation sedation

Pt fearful of nasal bobble

Question 3

Indications for paediatric IV sedation

Answer 3

Around 12 and above

Moderate to severe anxiety, and genuine phobia of dentistry

Special needs that impair cooperation

Previous cannulation success

Question 4

Contraindications for paeds IV sedation

Answer 4

<12

Mild anxiety

Needle phobia

Intellectual impairment where they cannot understand what is going on

Question 5

What is TCI?

Answer 5

Target controlled infusion - propofol

Useful for very long and short procedures

Rapid onset and rapid recovery