Conscious Sedation

Conscious sedation is the practice of providing sedation, relaxation and analgesia to patients undergoing procedures as outpatients, in the emergency room or the intensive care unit without undergoing the hazards of tracheal intubation. Proper monitoring devices must be used to assure maintenance of the airway and cardiovascular support. The level of sedation and amnesia required is determined by the procedure and the agitation of the patient. As a rule the patient should be given analgesics and sedatives with short onset of action and quick recovery times. Versed is commonly used as a sedative because of its short onset of action and lack of residual sedative effect. Sufentanil and alfentanil are superior to morphine and demerol in providing analgesia for short surgical and diagnostic procedures. Agents such as propofol and ketamine are best limited to the ICU where patients can be closely monitored for perturbations in their respiratory status. Effective monitoring of vitals allows for titration of the analgesic and sedative effects of these agents to provide effective anesthesia for procedures and diagnostic tests of short duration.

References

1. Cousins M, Bridenbaugh P. Neural blockade in clinical anesthesia and management of pain. Philadelphia: Lippincott-Raven, 1998.

2. Miller R et al, eds. Anesthesia. 5th ed. Philadelphia: Churchill-Livingstone, 2000.

3. Weinerkronish J, Gropper M. Consious Sedation. Philadelphia: Hurley & Belfus Inc., 2001.

4. Yaksh T et al, eds. Anesthesia biologic foundations. Philadelphia: Lippincott-Raven, 1998.

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