Sedation: Commonly Used Medications | Assessment and Management of Pediatric Trauma

Drug	Dosage	Effects	Duration	Pros	Cons
Midazolam (Versed)	PO: 0.25-0.5 mg/kg IN: 0.2 mg/kg IV: 0.1 mg/kg	Anxiolysis, amnesia, sedation/ hypnosis	45-60 min	Commonly used for treatment of anxiety and agitation. Multiple routes. Rapid onset. Hemodynamically stable	Hypoventilation, rare paradoxical reactions
Propofol	IV: 0.5-1 mg/kg	Sedation/ hypnosis	3-10 min	Commonly used for sedation. Rapid onset. Brief duration of action	Respiratory depression, hypotension
Ketamine	IM: 2-5 mg/kg IV: 1-2 mg/kg	Sedation/ hypnosis, analgesia	5-10 min	Commonly used for sedation. Maintains respiratory drive. Bronchodilator. Hemodynamically stable	Tachycardia, secretions, dissociative effects
Etomidate	IM: 3-4 mg/kg IV: 1-2 mg/kg	Sedation/ hypnosis	2-5 min	Used for sedation (usually when side effects of ketamine are not desired). Hemodynamically stable	Respiratory depression, myoclonus, adrenal suppression
Fentanyl	IN: 1.5 MCG/kg IV: 1-2 MCG/kg	Pure analgesia	30-60 min	Commonly used for analgesia alone or as an adjunct for painful sedated procedures. Hemodynamically stable	Respiratory depression
Nitrous oxide (N₂O)	INH: 25-50% with O₂	Sedation, analgesia	2-3 min	Inhalational technique. Patient can deliver medication themselves via mask. Rapid onset and offset. No respiratory depression.	Nausea. Patient must be compliant with mask. Greenhouse gas.
Dexmedetomidine	IV: 0.5-1 mcg/kg IV ggt: 0.2-0.5 MCG/kg/h	Sedation/ hypnosis, analgesia	1-2 h	Commonly used as an infusion for ongoing sedation or as an adjunct analgesic. No respiratory depression	Bradycardia, hypotension.

Module 6: Pediatric Trauma Analgesia and Sedation