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Open Access Special Issue

Procedural sedation and analgesia in the pediatric intensive care unit

  • Ivana Budic1,2,*,
  • Vesna Marjanovic1,2
  • Ivona Djordjevic2,3
  • Marija Stevic4,5
  • Dragoljub Zivanovic2,3
  • Dusica Simic4,5

1Clinic for Anesthesiology and Intensive Care, University Clinical Centre Nis, 18000 Nis, Serbia

2Medical Faculty, University of Nis, 18000 Nis, Serbia

3Clinic for Children’s Surgery, University Clinical Centre Nis, 18000 Nis, Serbia

4University Children’s Hospital, 11000 Belgrade, Serbia

5Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia

DOI: 10.22514/sv.2023.007 Vol.19,Issue 5,September 2023 pp.38-46

Submitted: 28 June 2022 Accepted: 30 August 2022

Published: 08 September 2023

(This article belongs to the Special Issue Pediatric Critical Care)

*Corresponding Author(s): Ivana Budic E-mail:


Children frequently experience more painful, stressful, and traumatic medical procedures and treatments in the pediatric intensive care unit (PICU) than when they are hospitalized in general wards. An essential part of care in the PICU is providing critically ill children with appropriate sedation and analgesia. Finding the perfect combination of adequate analgesia and sufficient sedation in a patient group with a wide range of ages, sizes, and developmental stages can be challenging. Administration of sedatives and analgesics to critically ill patients may be challenging and complicated by unpredictable pharmacokinetics (PK) and pharmacodynamics (PD). It is important to keep in mind that optimal agents for procedural sedation and analgesia (PSA) differ from those used for long-term sedation in the PICU. In addition to pharmacological measures, different non-pharmacological methods can be applied and have been shown to be effective for pain relief in children. Efforts are being made to improve PSA management with the use of national surveys, recommendations, and guidelines.


Procedural sedation; Procedural analgesia; Neonate; Child; Intensive care unit

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Ivana Budic,Vesna Marjanovic,Ivona Djordjevic,Marija Stevic,Dragoljub Zivanovic,Dusica Simic. Procedural sedation and analgesia in the pediatric intensive care unit. Signa Vitae. 2023. 19(5);38-46.


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