Where anaesthesia services are not available, ‘specialist’ drug techniques have been used by non-anaesthetists in the UK.
Ketamine, for example, is being used by emergency medicine doctors.
Provided the sedation failure rate is sufficiently small, the time investment may be worthwhile and anaesthesia resources can be saved.
Advanced techniques have a reduced margin of safety and should only be used by a specialist team.
Many children undergoing minor procedures need effective sedation, or anaesthesia, because they are frightened, in pain, ill, or have behavioural problems.
Levels of sedation have been defined by the ASA and they are widely accepted (Table 1).
In addition, the term ‘conscious’ sedation has remained in the UK.
Safety of any sedation technique is dependent upon the ability of practitioners to prevent or safely manage deeper levels of sedation.