Related Experiment Video
Updated: Apr 3, 2026
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Non-Parenteral Medications for Procedural Sedation in Children- A Narrative: Review Article
Razieh Fallah1, Farzad Ferdosian2, Ahmad Shajari3
1Pediatric Neurologist, Department of Pediatrics, Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Insights
Pediatric procedural sedation requires tailored approaches due to variable patient responses. This review focuses on non-intravenous sedation options for children, suitable for non-anesthesiologists.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Clinical Pediatrics
Background:
- Procedural sedation is essential for pediatric diagnostic and therapeutic interventions.
- Individual responses to sedation in children vary significantly, necessitating personalized protocols.
- Developing institutional protocols is crucial for ensuring the safety of pediatric procedural sedation.
Purpose of the Study:
- To review non-parenteral pharmacologic agents for procedural sedation in children.
- To provide guidance on selecting appropriate non-intravenous sedation methods for pediatric patients.
- To inform non-anesthesiologists about available non-parenteral sedation options for pediatric procedures.
Main Methods:
- Literature review of non-parenteral medications used for pediatric procedural sedation.
- Analysis of drug administration routes including oral, rectal, sublingual, buccal, aerosolized, and intranasal.
- Discussion of factors influencing drug selection, such as patient condition, procedure type, and pain level.
Main Results:
- Non-parenteral routes offer viable alternatives to intravenous sedation for pediatric patients.
- Various non-parenteral medications can be effectively administered via oral, rectal, sublingual, buccal, aerosolized, and intranasal routes.
- Selection criteria for non-parenteral agents consider child development, clinical context, and procedural specifics.
Conclusions:
- Non-parenteral sedation strategies are critical for safe and effective procedural sedation in children.
- This review highlights non-intravenous medications manageable by non-anesthesiologists.
- Tailoring sedation techniques based on individual patient needs and procedural demands is paramount.
Abstract:
Procedural sedation may be needed in many diagnostic and therapeutic procedures in children. To make pediatric procedural sedation as safe as possible, protocols should be developed by institutions. Response to sedation in children is highly variable, while some become deeply sedated after minimal doses, others may need much higher doses. Child developmental status, clinical circumstances and condition of patient should be considered and then pharmacologic and non-pharmacologic interventions for sedation be selected. Drug of choice and administration route depend on the condition of the child, type of procedure, and predicted pain degree. The drugs might be administered parenteral (intravenous or intramuscular) or non parenteral including oral, rectal, sublingual, aerosolized buccal and intranasal. The use of intravenous medication such propofol, ketamine, dexmedetomidine, or etomidate may be restricted in use by pediatric anesthesiologist or pediatric critical care specialists or pediatric emergency medicine specialists. In this review article we discuss on non-parenteral medications that can be used by non- anesthesiologist.
