Simpson et al listed a number of conditions and situations that may cause problems with sedation of a child who is having a CT scan performed. The authors are from Dumfries and Galloway Royal Infirmary in Dumfries, Scotland.


Patient selection: pediatric patient prior and during CT scan


Sedation is administered by nonanesthetists in the Radiology Department.


Reasons either to not sedate or to use precautions:

(1) acute or potential airway obstruction

(2) increased risk for aspiration of gastric contents (persistent vomiting, abdominal distension, severe gastroesophageal reflux)

(3) respiratory failure

(4) severe hepatic dysfunction

(5) severe renal dysfunction

(6) raised intracranial pressure


Additional problems may arise if:

(1) the child has not been adequately fasted (at least 4 hours prior)

(2) the child is severely agitated and hard to control

(3) nothing is known about the child (no opportunity to evaluate prior to the procedure)

(4) no one will be able to monitor the child after the procedure (during recovery)


If one or more problems are identified then sedation should be postponed pending resolution or consultation with anesthesiology.


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