Pediatric Procedural Sedation: Risk Factors for Serious Adverse Events

Researchers assessed the incidence of sedation-related serious adverse events (SAEs) and risk factors for them in a prospective cohort study of children ≤18 years of age presenting to six Canadian pediatric emergency departments (EDs) and requiring sedation for painful procedures.

Of 6295 patients (mean age, 8 years), 736 (12%) experienced 831 adverse events, most commonly oxygen desaturation (6%) and vomiting (5%). SAEs occurred in 69 patients (1%) and included apnea in 55 (1%) and hypotension, laryngospasm, and bradycardia (each 0.1%). Significant interventions (most often positive pressure ventilation) were performed in 86 patients (1%).

Sedation medication was the only risk factor for SAEs. Compared with ketamine alone (median total dose,…