Oral Medications

Midazolam, the most commonly used oral sedative in children, is used primarily as a premedication but can also be beneficial in brief, minimally invasive procedures, with few side effects. Ketamine can be used for brief, painful procedures but can cause vomiting. Dexmedetomidine can be used as a premedication but has not been extensively studied. Chloral hydrate is useful for imaging studies and noninvasive procedures but is limited by its prolonged sedative effects. Melatonin can be used for sedation and anxiolysis for imaging and noninvasive testing, but there is conflicting literature about its analgesic effects. There are limited studies on the use of meperidine and hydroxyzine for dental procedures. Ketamine and dexmedetomidine intravenous preparations have been administered enterally. Melatonin and clonidine are enteral medications that may prove useful in pediatric procedural sedation. In general, enteral administration is associated with preprocedural anxiolysis, uneven bioavailability, and unpredictable onset of action and recovery times.