Pediatric Sedation Outside of the Operating Room: A Multispecialty International Collaboration

898 Pages·2020·31.819 MB·English

by  Keira P. Mason

Keira P. Mason
Editor
Pediatric
Sedation Outside
of the Operating Room
A Multispecialty International Collaboration
Third Edition
123
Pediatric Sedation Outside of the Operating
Room
Keira P. Mason
Editor
Pediatric Sedation Outside
of the Operating Room
A Multispecialty International Collaboration
Third Edition
Editor
Keira P. Mason
Department of Anaesthesia
Harvard Medical School
Boston, MA
USA
ISBN 978-3-030-58405-4 ISBN 978-3-030-58406-1 (eBook)
https://doi.org/10.1007/978-3-030-58406-1
© Springer Nature Switzerland AG 2021
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This book is primarily dedicated to my mother and father, whose sacrifice,
love, and encouragement enabled me to pursue my goals and dreams.
Leading by example, they showed me to persevere, remain positive,
optimistic, and always strive to achieve my personal best. Thank you, God,
for blessing me with the gift of my two sons, Tyler and Colin. I will continue
to strive to guide, nurture, be a role model for and provide for them, as my
parents did for me.
Preface
I am honored and thrilled to present within the relatively short span of only 5 years, this
updated and expanded 3rd edition. All 47 book chapters were received within 6 months of
book publication – presenting the reader with a completely up-to-date book! The most recent
chapters were updated in December, 2020! Every chapter in this book has been updated and
there are 12 brand new chapters. All authors are pioneers and world leaders in their areas of
expertise, both in the United States and abroad, not only in the field of sedation but also in the
areas of law, ethics, child psychology, child development, pediatrics, neonatology, simulation,
drug development, patient safety, emergency medicine, intensive (pediatric and neonatal) care
medicine, anesthesia, dental anesthesia, dental medicine, psychiatry, neurology, behavioral
medicine, and pharmacology. This book is a testimony to the passion and commitment of all
the contributing authors to advance the knowledge and practice of pediatric sedation. Pediatric
Sedation Outside of the Operating Room: A Multispecialty International Collaboration is
intended to represent and be applicable to sedation providers of any specialty from around the
world. Our international contributors represent Australia, Belgium, Brazil, Chile, China, Israel,
the Netherlands, New Zealand, South Africa, Switzerland, and the United Kingdom. I am very
appreciative of their efforts and I extend a sincere “thank you” to each author.
There are 12 new chapters in this book, exploring current, evolving, and anticipated relevant
topics in sedation. Even the updated chapters, for example, Improving the Safety of Pediatric
Sedation: Human Error, Technology, and Clinical Microsystems, is so up-to-date to include not
only issues facing the Boeing MAX but also a detailed description of the June 2018 cave res-
cue in Thailand of the 12 young boys and their coach that were extracted in a water rescue
requiring sedation. This chapter is unique in that Dr. Richard Harris, the anesthesiologist from
Australia who was on-site and directly involved in orchestrating, directing, and administering
the sedation and performing the cave rescue, is one of the authors of this chapter! Additional
exciting new chapters that address pertinent new issues include Considerations for the
Intersection of Sedation and Marijuana; Behavioral Techniques for Anxiolysis and Sedation;
The Autistic Spectrum: Clinical Aspects and Approaches to Sedation; Sedation for End of Life:
A Holistic Approach; Fasting Status, Aspiration Risk, and Sedation Outcomes; Neuromonitoring
and Sedation; Is There a Role?; Sedation of the Obese Child: Essential Considerations;
Adverse Events: Risk Factors, Predictors and Outcomes; and Sedation Strategies and
Techniques for Painful Dental Procedures.
This book is a unique and authoritative contribution to the field of pediatric sedation. It is
directed to all specialties and specifically acknowledges and reviews the contributions and
viewpoints of a broad range of international societies and specialists. Sedation has evolved to
include all specialties. Although each chapter is written by an expert and world-renowned
specialist(s) in his/her particular area, it is intended to be of value to those who do not neces-
sarily practice in that area. For example, the pediatrician in the United States will learn some-
thing in the Pediatric Sedation in South America chapter that can be applied or considered for
his or her own practice. Chapters specifically written by clinicians and scientists in Asia,
Africa, Europe, South America, Australia and New Zealand, explore sedation practice in these
countries and continents.
vii
viii Preface
The chapters that are clinically oriented conclude with Case Studies, which present chal-
lenging clinical scenarios. This is a unique finale as it is the author’s presentation of real-life
cases. The intent of these Case Studies is to guide the reader through the challenges, thought
processes, and management options for each situation. Certainly, there are many possible solu-
tions to each scenario. Exploring them through the eyes of the experienced author offers a
unique and valuable perspective.
This book may be read cover to cover or read a chapter at a time, out of succession. There
is intentional, albeit minimal, repetition in the book. The repetition is intended not only to
solidify important information for the reader, but also to convey relevant information for those
who may not be reading the book cover to cover. Even the “repetition” is presented in a differ-
ent style by the individual authors, in most cases masking the repeated elements.
The final form of this book went to the publisher in January, 2021. Every chapter was
updated in even those final weeks with any recently published papers.
This book represents a global collaboration. Currently, the field of sedation is being chal-
lenged by politics, differing viewpoints and our inability to reach a consensus. Our ability to
come together, outside of this book, will be essential to the future of our pediatric patients who
receive sedation.
There will continue to be new clinical and research studies that advance our knowledge of
sedation. New sedatives, physiological monitors, and sedation delivery systems will certainly
be introduced over the next decade. Regardless, the approach to sedation and the information
conveyed in these chapters is intended to distinguish this book as a timeless relic that marks an
important era in the field of sedation.

Boston, MA, USA Keira P. Mason
January 11, 2021
Acknowledgments
The most important and heartfelt acknowledgment is to my family. Thank you
to my two sons, Colin and Tyler, for accepting some “motherless” weekends
and evenings throughout my career, as I traveled and shared my passion for and
knowledge of sedation with colleagues worldwide. You have, albeit unknow-
ingly, indirectly supported me not only for this book but also throughout my
career: Understanding that sharing sedation experience with others to advance
the practice, safety, and knowledge of sedation is my passion and has taken me
away from home, even missing on occasion some of your important events.
Thank you, Tyler, for sitting beside me in the early morning and late-night
hours to read over my shoulder, encouraging and helping me edit and revise
chapters. Thank you, Colin, for your efforts in helping me organize the book
and come up with new ideas for book chapters. I am so proud of you both and
honored to be your mother.

I would like to express my respect, gratitude, and appreciation to Gregory
Sutorius, Senior Editor for Clinical Medicine, and Lorraine Coffey, Developmental
Editor, at Springer. Thank you both for agreeing to the short deadline from incep-
tion of the third edition, to receiving the chapters, editing them, formatting the
ix
x Acknowledgments
book, and presenting it published in 6 short months! Your gentle prodding, atten-
tion to detail, kindness, expertise, and professionalism has inspired me to meet all
deadlines. Most importantly, you both were committed to this project committed
to supporting all efforts to produce Pediatric Sedation Outside of the Operating
Room as a contribution to the field.
My final acknowledgment is to Ms. Kimberly Manning. From the inception
of the 3rd edition of this book to the final moments of its galley proof approval,
you devoted even the after-h ours ensuring that all references, figures, tables,
and source information were accurate, the grammar and typos corrected, the
copyrights were obtained, and that everything from the table of contents to the
final chapter flowed appropriately. You caught mistakes that would have gone
unnoticed. I have esteem for your commitment to this edition: your organiza-
tion, encouragement, tireless enthusiasm, and sleuthing skills to uncover
important contributions to this book were invaluable. I will always be
appreciative.
Contents
Part I Pediatric Sedation Outside the Operating Room
1 The History of Sedation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Robert S. Holzman
2 Sedation Policies, Recommendations, and Guidelines Across
the Specialties and Continents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Joseph P. Cravero
3 Procedural Sedation: Let’s Review the Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Vincent W. Chiang and M. Saif Siddiqui
4 Pre-sedation Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Timothy Horeczko and Mohamed Mahmoud
5 Sedation Scales and Discharge Criteria: How Do They Differ?
Which One to Choose? Do They Really Apply to Sedation? . . . . . . . . . . . . . . . . . . 83
Dean B. Andropoulos
6 Physiological Monitoring for Procedural Sedation . . . . . . . . . . . . . . . . . . . . . . . . . 95
Cyril Sahyoun and Baruch S. Krauss
7 Neuromonitoring and Sedation; Is There a Role? . . . . . . . . . . . . . . . . . . . . . . . . . .107
Neena Seth
8 The Pediatric Airway: Anatomy, Challenges, and Solutions . . . . . . . . . . . . . . . . .125
Lynne R. Ferrari
9 Pediatric Physiology: How Does It Differ from Adults? . . . . . . . . . . . . . . . . . . . . .141
Dean B. Andropoulos
10 Capnography: The Science, Logistics, Applications, and Limitations
for Procedural Sedation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Bhavani Shankar Kodali
11 Clinical Pharmacology of Sedatives, Reversal Agents, and Adjuncts . . . . . . . . . .171
Randy P. Prescilla
12 The Pharmacology, Physiology and Clinical Application
in Dentistry of Nitrous Oxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199
Dimitris Emmanouil
13 Sedation of the Obese Child: Essential Considerations. . . . . . . . . . . . . . . . . . . . . .211
Tom G. Hansen and Thomas Engelhardt
14 Sedation; Is it Sleep, Is it Amnesia, What’s the Difference? . . . . . . . . . . . . . . . . . .223
Robert A. Veselis and Vittoria Arslan-Carlon
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