What is sedation analgesia?
Sedation analgesia involves the use of medications to achieve a desired level of consciousness in patients who are about to undergo specific surgical, dental, or medical procedures. The goal of sedation analgesia is to keep patients comfortable, relieve pain, and reduce the anxiety that often accompanies medical/surgical treatments and procedures.
What levels of consciousness can be achieved with the use of sedation analgesia?
The levels of sedation that can be achieved can range from a high state of consciousness to unconsciousness. The levels of sedation, described more fully below, are variable and depend both on the medication(s) and dosages used as well as the patient’s individual response to the medications.
Anxiolysis:
This type of sedation analgesia reduces or eliminates pain and anxiety in a conscious patient. The patient is easily awakened by normal or softly spoken verbal commands and will be able to follow instructions.
Moderate sedation/analgesia:
With this type of sedation analgesia (also called conscious sedation), patients feel drowsy and are unable to hold a conversation but can respond to commands with appropriate action or brief response. Patients can be easily awakened when spoken to or touched.
Deep sedation/analgesia:
With this type of sedation analgesia, the patient cannot respond to verbal commands or physical stimulation and is not easily aroused by touch. Patients sleep through their procedure with little or no memory of the event.
General anesthesia:
When this type of anesthesia is used, patients are completely unconscious. During the procedure, patients are unaware of what is happening and have no memory of the procedure.
How is the choice of specific sedation analgesia to be used made?
Your team of physicians, surgeons, and anesthesiologists (doctors specially trained to administer all levels of sedation) will determine what type of sedation analgesia is needed for you based on the procedure itself, your medical status, and the level of sedation analgesia required to complete the procedure.
As far as your personal health history, your health care team will take into consideration such factors as your age and current medications. They will also ask if you are pregnant or have any history of the following:
- abnormalities of major organ systems including heart, lungs, and kidneys,
- adverse or allergic reactions to anesthesia or sedation analgesia
- tobacco, alcohol, or substance use/abuse
Your health care team will also review your vital signs, conduct cardiopulmonary and airway examinations and order laboratory tests if deemed necessary.
In choosing the most appropriate sedation analgesia, members of your health care team will discuss with you (or your legal guardian) the risks, benefits and alternatives of the proposed sedation analgesia method.
How is sedation analgesia administered?
Sedation analgesia is usually administered through an IV. Depending on the procedure, you may receive local anesthesia, administered at the procedural site, in addition to sedation.
How is my sedation analgesia monitored over the course of the procedure?
One health care team member with appropriate training will have the primary responsibility of monitoring your vital signs (e.g., your heart rate, blood pressure, respiratory rate, level of oxygen in your blood) and controlling your level of consciousness before and during your procedure; and for monitoring your vital signs during your recovery.
How long do I need to refrain from eating prior to my procedure?
The following are the general, minimal, fasting guidelines:
- Do not consume a "regular meal" within 8 hours of your procedure time
- Do not consume a "light meal" (e.g., toast and clear liquids) within 6 hours of your procedure time
- Do not consume clear liquids (e.g., water, fruit juice without pulp, carbonated beverages, clear tea, black coffee) within 2 hours of your procedure time
Your physician will give you specific instructions about what you may or may not be able to eat prior to your procedure.
What going home plans must I have in place?
If you have received moderate or deep sedation analgesia, you will spend an hour or more in the recovery room. If you are an outpatient, you will not be discharged until the effects of the medication(s) have worn off. IMPORTANT: You must bring a responsible person with you to drive you home – this transportation arrangement must be made before you are sedated. You should not drive until you have had a night’s sleep after your procedure.
If you have received moderate or deep sedation analgesia, you will spend an hour or more in the recovery room. If you are an outpatient, you will not be discharged until the effects of the medication(s) have worn off. You bring a responsible person with you to drive you home –this transportation arrangement be made before you are sedated. You should not drive until you have had a night’s sleep after your procedure.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/8/2005...#12321
