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This level, called moderate sedation/analgesia or conscious sedation, causes a drug induced depression of consciousness during which the patient responds purposefully to verbal commands, either alone or accompanied with light physical stimulation. Breathing tubes are not required for this type of anesthesia. This is twilight anesthesia. [2]
Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own.
Conscious sedation and monitored anesthesia care (MAC) refer to an awareness somewhere in the middle of the spectrum, depending on the degree to which a patient is sedated. Monitored anesthesia care involves titration of local anesthesia along with sedation and analgesia. [18] Awareness/wakefulness does not necessarily imply pain or discomfort.
Sedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death).
The purpose of anesthesia can be distilled down to three basic goals or endpoints: [2]: 236 hypnosis (a temporary loss of consciousness and with it a loss of memory.In a pharmacological context, the word hypnosis usually has this technical meaning, in contrast to its more familiar lay or psychological meaning of an altered state of consciousness not necessarily caused by drugs—see hypnosis).
The pharmacological agents used differ depending on patient, level of sedation desired and medical professional administering the sedation medications. The medications can belong to a class of drugs called sedatives, which exert their action by depressing the central nervous system, specifically those areas concerned with conscious awareness ...
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Mild or moderate sedation can be induced with medications such as midazolam (a benzodiazepine with sedating, amnesiac qualities), fentanyl (an opioid), or propofol (a sedative/general anesthetic, depending on dosage). Children are anesthetized. Adults are sometimes anesthetized as well if moderate sedation is unsuccessful. [citation needed]