Sedation for Children

Age Requirement

Paediatric procedural sedation is provided only for children aged three years and older. Children under three require specialised anaesthetic care in a hospital setting. This threshold is based on SASA guidelines and reflects the physiological differences that make very young children unsuitable for sedation outside a hospital operating theatre.

How Paediatric Sedation Works

Dr Nienaber works closely with your child's dentist or doctor to create a calm, reassuring environment. You may remain with your child until sedation begins and they feel relaxed. Local anaesthetic cream is applied to the hand or arm beforehand to minimise discomfort from the IV insertion. Bringing your child's favourite comfort item — a blanket or toy — is encouraged.

Using Target Controlled Infusion (TCI) technology, sedation is delivered with precision and adjusted continuously to your child's individual response. Your child will feel drowsy and relaxed, and most children have no memory of the procedure afterward.

Throughout the procedure, Dr Nienaber continuously monitors your child's heart rate, oxygen saturation, blood pressure, ECG, and breathing. Full resuscitation equipment and drugs are present at every case. Dr Nienaber remains with your child from the moment sedation begins until they are safely in recovery.

How to Prepare Your Child

Medical Preparation

Complete and submit your child's medical history form accurately, including all medications, allergies, medical conditions, and previous reactions to sedation or anaesthesia. Inform Dr Nienaber immediately if your child becomes unwell before the procedure — even minor illnesses may require postponement for safety.

Fasting Requirements

These requirements are essential for your child's safety and must be followed precisely.

• Cease all solid foods and milk at least 6 hours before the procedure
• Cease breast milk 4 hours before the procedure
• Cease clear fluids (water, apple juice) 2 hours before the procedure
• If your child takes chronic medication, administer it on the day of the procedure only after consulting Dr Nienaber

Day of Procedure

• Dress your child in comfortable, loose-fitting clothes with easy-access sleeves
• Ensure your child has emptied their bladder before the procedure
• Arrive at least 30 minutes early for preparation and assessment
• You may remain with your child until sedation begins and they feel relaxed
• Local anaesthetic cream may be applied beforehand to minimise discomfort from IV insertion
• Bring your child's favourite comfort item if appropriate

Sedation will not be provided if your child arrives without an appropriate adult escort.

What to Expect After the Procedure

Immediate Supervision

A responsible adult must take your child home and remain with them for the entire remainder of the day. Never leave a sedated child unattended, even for brief moments. Your child will be unsteady and require help walking for several hours.

Normal Effects in Children

The following are entirely normal and will resolve on their own. There is no cause for alarm.

• Approximately 20% of children experience double vision or blurriness lasting up to 6 hours
• Temporary memory loss of the procedure
• Increased emotional responses — more crying, clinginess, or desire for extra comfort
• Some children may be temporarily more irritable or occasionally aggressive
• Coordination difficulties requiring assistance with walking
• Temporary amnesia lasting a few hours

Safety Restrictions (12+ Hours)

• No activities requiring alertness or coordination (swimming, cycling, playground equipment)
• Keep away from potentially hazardous areas: kitchen, bathroom, stairs, pools of water
• After dental procedures: watch carefully that they do not bite their numb lip or tongue
• No climbing, bicycles, scooters, or similar equipment
• Avoid hot surfaces and sharp objects

Recovery Care

• Introduce fluids slowly once your child is awake and alert
• Start with small sips of water, progressing to normal foods only when fluids are well tolerated
• Do not force eating or drinking if your child feels unwell
• Allow extra rest and provide comfort as needed — extra cuddles and reassurance are entirely normal
• Interfere as little as possible with your child's natural recovery process

Trust your instincts. If you are concerned about your child's recovery, contact Dr Nienaber immediately. Normal recovery varies — some children recover faster than others. Be patient.

Important Reminders for Parents

• Submit all forms to forms@sasedation.co.za at least 24 hours before the procedure
• Age requirement: only children aged 3 years and older can receive procedural sedation
• Escort requirement: no sedation will be provided without a responsible adult escort
• Your child's procedure may be postponed if they are unwell or fasting requirements are not met
• If anything is unclear, contact Dr Nienaber before your appointment

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