The Premature Infant

Preterm and former preterm infants present unique challenges for sedation providers. These children represent a heterogeneous high-risk population who frequently require sedation or anesthesia for diagnostic and therapeutic procedures. They have limited physiologic reserve and immature metabolic functions. Prematurity is associated with an increased risk for sedation adverse events, including death. Understanding the anatomic and physiologic differences between preterm and term children is necessary for the development of a sedation plan. One of the most important differences pertains to the airway and respiratory system, so airway management is a critical component of the sedation plan. Preterm neonates have altered pharmacokinetics and pharmacodynamics, so titration of sedative drugs is recommended.