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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.

It does not cover sedation for intensive care or anxiolytic premedication before anaesthesia.

Conscious sedation is unlikely to be successful in infants and small children.In addition to understanding the current medical and surgical problems, the sedationist should assess the child's growth, previous sedation or anaesthesia, and the drug history.The examination should identify any physical abnormalities, particularly those of the airway.Four common scenarios, listed in Table 2, require specific sedation techniques.Children who refuse to undergo a procedure ‘awake’ are difficult to sedate to the moderate or conscious level.

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