pediatric sedation - moderate vs anesthesia

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    We're currently having a debate at work about pediatric patients under the age of 8. The nurses feel that general anesthesia is the kindest, safest way to go with young children. Two of the docs are resistant to this. We recently had a bad experience with moderate sedation on a one-month old which has brought the issue to the attention of risk management. They are asking what is the standard of care for sedation on young pediatric patients. So tell me, how do other places sedate little ones?
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    I can only speak from the experience of a mother of a child with a lot of GI issues. I cannot tell you how horrific it was for me to experience the pulling of my daughter's Bard button without sedation. It was barbaric and cruel to pull that device out of the small and still healing stoma. It's like pulling an earring out of your ear without taking the back off, but on a bigger scale.

    Before the procedure I had asked if she could be lightly sedated or at least given some versed and was told abosolutely not because it wasn't standard procedure. I asked if I could sign a waiver or talk to the doctor about the risk factors and see if I could convince him to consider this and was told over and over NO. I had no other choice.

    She was traumatized for weeks after that when it came to dealing with strangers even saying hello to her in public. Before that she was pretty trusting and happy.

    I have heard from another mom whose child just had his Bard pulled that they now give a little gas to calm the child and make them not remember it. I'm so glad things have changed at Phoenix Children's Hospital!

    I am part of an online group for kids who have tubes and/or GI issues, and it seems to be standard procedure most places to give mild sedation for procedures done in the office. They also sedate for scopes unless the child is at risk for sedation.

    I can see why it would be risky for some children that are not good candidates for sedation, such as kids with seizure disorders.

    I also wish that more doctors would try steriod cream for granulation tissue and use silver nitrate sticks as a last resort. The SN hurts and is scary. The steriod cream is more effective in the long run (does not grow back as fast) and no pain and no need to hold down a crying child. Just wanted to add my two cents on that.
    Last edit by AmericanChai on Nov 10, '06


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