Sedating Pediatric Patients for Gastrointestinal Endoscopy Procedures: Dosage Ranges Frequently Exceed Recommended Guidelines

Sedation for Pediatric Endoscopic Procedures

“…Overall, it is found that to produce adequate sedation for pediatric gastrointestinal endoscopic procedures, recommended dosage guidelines may need to be exceeded. Fortunately, adverse events occur only rarely under these circumstances (65). Conscious sedation should be performed only by individuals trained in pediatric resuscitation with appropriate equipment.…”

“…Thus, in neonates, the dosage of these medications are lower than in the adult to achieve the same level of sedation (68). In children up to 2.5 months of age, renal clearance is immature, requiring a lower dose of diazepam, which is cleared through the kidneys (8,65). Midazolam is metabolized and excreted much more rapidly in children than in adults, leading to the need for repeated doses of midazolam during a procedure (58).…”

“…Midazolam is metabolized and excreted much more rapidly in children than in adults, leading to the need for repeated doses of midazolam during a procedure (58). Interestingly, despite these physiologic and pharmacologic features of children that generally suggest lower sedation doses, children usually require higher doses of a sedative to achieve similar levels of sedation for a given procedure compared with an adult (60,65).…”