Answer:
A combination of fentanyl and midazolam is probably the best regimen for sedating a child. Fentanyl is avaible in oral form, oral transmucosal fentanyl citrate (OTFC) in a sweetened matrix lozenge (fentanyl lollipop). Dosage is 10-15 mcg/kg, onset of action 12-30 minutes, and duration of action 20-30 minutes. Midazolam can be given IV, IM, nasal, oral or rectal. Dosage is 0.05 to 0.15 mcg/kg. Duration of action is about 30 minutes. Onset of action is 1-3 minutes given parenterally, and 30 minutes orally. Ketamine is a good alternative because it has analgesic, sedative and amnesic properties (1-2 mg/kg). Onset is about 5 minutes parenterally and duration of action 15-30 minutes.