Pediatric sedation: can it be safely performed by non-anesthesiologists?

The purpose of the present review is to provide the reader with a synopsis of the recent literature on sedation of children by non-anesthesiologists.

Health care centers are experiencing an increasing demand for sedation of pediatric patients. Whether provided by physician anesthesiologists, nurse anesthetists, or appropriately credentialed non-anesthesia clinicians, this increase is a reflection of new advances in the area of diagnostic imaging, better pharmacologic agents, and a heightened awareness of the psychologic needs of children. By definition anesthesiologists are the experts when it comes to providing sedation to patients. For pediatric patients, pediatric anesthesiologists provide the most appropriate specialization. However, because of insufficient manpower, anesthesiologists cannot adequately meet the increasing workload of providing sedation for each child in need.

In some circumstances the incidence of adverse events when sedation is provided by non-anesthesiologist can be high. Predicators of adverse outcome have been identified. Given strict adherence to sedation guidelines and appropriate credentialing of the sedation provider, non-anesthesiologists can safely provide sedation for children.