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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.
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]
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 is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane , diethyl ether , propofol , etomidate , ketamine , pentobarbital , lorazepam and midazolam .
Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia, premedication before surgical anesthesia, and procedural sedation, and to treat severe agitation. [12] It induces sleepiness, decreases anxiety, and causes anterograde amnesia. [12]
Oral sedation is one of the available methods of conscious sedation dentistry, along with inhalation sedation (e.g., nitrous oxide) and conscious intravenous sedation. [citation needed] Benzodiazepines are commonly used, specifically triazolam. [1] Triazolam is commonly selected for its rapid onset and limited duration of effect. [1]
(01916–01936) radiological procedures (01951–01953) burn excisions or debridement (01958–01969) obstetric (01990–01999) other procedures (99100–99140) qualifying circumstances for anesthesia (99143–99150) moderate (conscious) sedation
It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.