Introduction There is a lot of debate in The Netherlands about the safety and effectivity of procedural sedation, mainly given by paediatricians. A new sedation protocol was introduced in December 2004.

Objective To evaluate a sedation protocol for successful procedures, and to study adverse events.

Methods Prospective observational study of all children admitted at the day-care unit for non-invasive diagnostic procedures during one year.

The protocol describes a step-up procedure consisting of chloralhydrate followed if needed by midazolam intravenously. Patients were sober according to the nil per os guidelines. A paediatric nurse was responsible for the child all the time. Oxygen saturation and heart rate, after midazolam also respiratory rate, were monitored. Resuscitation equipment was with the patient all the time.

Adverse events were defined as apnea, airway obstruction, loss of consciousness or elongated stay. Discharge took place when vital parameters and behaviour were as before sedation, and after drinking. One paediatric radiologist judged each brain MRI on how well the clinical question could be answered.

Results Of 101 procedures the success rate was 94%. Of 68 brain-MRIs, 63 (93%) were successful. There were no adverse events.

Conclusion Implementation of this sedation protocol has lead to a high success rate for non-invasive diagnostic procedures, without adverse events.