Sedation for pediatric endoscopy

Sedation is a fundamental component of pediatric gastrointestinal procedures. Although anesthesiologist-administered sedation is becoming more common, to date, no ideal regimen has been identified for endoscopy in children. The 2 main types of pediatric sedation remain general anesthesia, which requires the presence of an anesthesiologist, and procedural sedation, which may be administered by the gastroenterologist. In choosing between the 2 for a child's procedure, it is critical to maintain patient safety, while maximizing procedural efficiency and minimizing costs. In this chapter, we discuss levels of sedation for endoscopy, as well as various regimens that can be used to achieve them. We also review risks and considerations that may be specific to performing gastrointestinal procedures in children. Finally, we examine potential future directions for sedation, which may fundamentally change the practice of procedural gastroenterology and ultimately patient outcomes.