Sedation - Procedural sedation

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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At times part of diagnosing and treating an illness means that children need a procedure.  Some procedures are very simple, quick and have no pain associated with them. Others require children to stay still for a long period. Some can be uncomfortable and may cause pain and distress.

Staff will always try to reduce the uncomfortable, painful or stressful part of procedures as much as possible.

Before you come to hospital for the procedure, the best thing you can do is to prepare your child at home.  Always answer any questions your child may have.  (See fact sheet ‘Children’s painful procedures and operations: how can parents help?’)

If your doctor has asked your child to fast (not eat or drink) for a certain period before coming in to the procedure, you must follow this instruction. Fasting reduces the chance of your child choking during sedation. If you are not sure about the fasting instructions please contact the doctor who is performing the procedure or the ward/unit where the procedure is going to occur.

Before the procedure, a nurse or your child’s doctor will check your child to help decide how to best manage any pain or distress staff will need to ask about your child’s health, any past experiences or anxieties, your family history, and they may need to examine your child. It is important to tell us if your child snores or has had past problems with anaesthetics.

Your child may need some medicine to prevent and/or relieve pain, reduce anxiety or sometimes to make them sleepy and able to lie still. Analgesics are medicines that reduce your child’s pain, but there are other things that may upset your child such as strange places, noises, and people, or having to lie still. Sedatives (drugs that make you sleepy) may be offered to make these things less stressful.  There are many different types and ways of giving both these types of medicines, such as syrup, tablets, needles and breathing nitrous oxide (laughing gas). Your child’s doctor will discuss this with you and your child, and explain how sleepy they may make your child, what the side-effects could be, what risks there are, and how long these medicines can affect your child. You should ask questions so that you and your child can help make the choices that suit best.

Once your child has been given the medicines, he/she should be kept on your lap or in a bed or cot.  If they are in a bed or cot and you are not sitting right beside them, the sides should be in the up position. If your child is very sleepy, he/she should be put in the cot or bed lying flat or on the side.

Your child will need to be observed until the medicine takes effect, throughout the procedure, and until the effect of the medication wears off.  Your child may be a little uncoordinated or clumsy so please ask for help if you are worried. Depending on the medicines, your child may need to be monitored from the time they are sleepy until they are fully awake. This usually is done by placing an ‘oximeter’ probe on their finger (a machine with a little peg or clip that shines a light at the finger). This machine will show their blood oxygen level and heart rate. Staff will also frequently check for any pain or distress and will help you to manage this.

Your child will be checked by a nurse and allowed to go home once he/she is fully awake and back to normal as long as an adult is able to provide care for the rest of the day. You will be given discharge instructions before you leave so that you know what to do.

Children often want to go back to sleep after sedation so it is best for them to be lying down in a pram or bed. If your child is taken home by car, it would be best to have someone in the back to make sure that your child does not slump in the car child restraint. Your child’s head should be upright and supported during the trip.

Adolescents should not drive or use heavy machinery for 12 - 24 hours after sedation (depending on the medicines used).

Remember

  • On the day of the procedure, please bring your child’s favourite book, music, or even a small game to play!
  • As a parent, you play a very important role in assisting your child to cope with medical procedures that can be distressing and uncomfortable through a calm approach and reminders to focus on distraction and/or relaxation.
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The Children's Hospital at Westmead
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Sydney Children's Hospital, Randwick
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Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

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