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With this practice increasing, the debate about safety and the practitioner core competency requirements to provide sedation and/or analgesia to the complex pediatric patient with developmental disabilities and neurologic disorders has also increased and several policy statements have been published by different professional societies [2], with no clear evidence of practice standards and incidence of adverse outcomes.

To aid in the investigation of the practice and potential adverse outcomes associated with the delivery of sedation outside the operating room, the Pediatric Sedation Research Consortium (PSRC), a collection of 37 institutions that share information on sedation practices within their individual institutions, has created a self-reporting prospective, observational database.

These findings seem to recapitulate the findings described in the PSRC studies: an increase in adverse events, most notably airway compromise, for children with developmental disabilities and those with neurologic disorders.

Sedation and analgesia for the pediatric patient with developmental disabilities and neurologic disorder require a thorough understanding of potential adverse events, and the knowledge and skill to avoid potentially life-threatening complications from the administration of sedative and analgesic medications.

In addition, the practitioner must focus particular attention on the entire periprocedural period including presedation evaluation, sedation/analgesia administration, and recovery.

In another study, a small observational chart review performed by Elwood et al.

suggests that the anteroposterior oropharyngeal airway diameter was smaller in children with developmental delay than in those without developmental delay, in static MRI images [9].

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