Echocardiography is a noninvasive ultrasonography tool used to examine the heart. It is useful for analyzing the anatomy, physiology, and functions of the heart; And is considered essential for diagnosing heart disease and defects in infants and children. However, conducting a proper echocardiogram on younger patients can be a considerable challenge due to their crying, screaming, and persistent resistance to sitting still. The objective of this review article is to compare the different sedative drugs used in pediatric patients to achieve cooperation during an echocardiogram. There are also other more traditional methods of minimizing cooperation problems such as feeding and distracting the patient, which will be discussed briefly to help evaluate the difference in diagnostic errors in pediatric patients that are sedated versus not.

For the evaluation of children with congenital and acquired heart diseases, Transthoracic Echocardiography (TTE) is the most efficient imaging modality. A TTE can provide the structural, functional, and postural defects that cause heart disease in pediatric patients. It is important to get reliable echocardiogram results because most management decisions are based on echo findings rather than invasive procedures like cardiac catheterizations. A cooperative patient is essential for a thorough and error-free echocardiogram. It can be difficult to achieve optimal results in young children, as with other pediatric procedures. Therefore, many centers now routinely use sedatives to perform echocardiograms in young children. Some of the different types of sedatives used in pediatric patients include anxiolytic drugs, hypnotic drugs, analgesic drugs, and in rare cases opioid agonists for pain management. In a normal echocardiogram, midazolam is sufficient, whereas in a transthoracic echocardiogram more powerful immobilizing drugs like chloral hydrate is preferred. Other sedatives commonly used in children include dexmedetomidine, phenobarbital, and pentobarbital. There are, however, risks associated with sedating young children.

With Best Regards,
Tony Wilson
Journal Coordinator
Insights in Pediatric Cardiology