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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.
Sedoanalgesia is the practice of combining sedation with local anesthesia, usually in the case of surgery.In medical studies, administering sedoanalgesia has been shown to be cost- and time-effective when compared to general or regional anesthesia, and it can reduce the amount of nursing staff, anesthetists, and equipment required for a given procedure.
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).
Regional anesthesia, for instance, affects analgesia; benzodiazepine-type sedatives (used for sedation, or "twilight anesthesia") favor amnesia; and general anesthetics can affect all of the endpoints. The goal of anesthesia is to achieve the endpoints required for the given surgical procedure with the least risk to the subject.
Stage I (stage of analgesia or disorientation): from beginning of induction of general anesthesia to loss of consciousness. Stage II (stage of excitement or delirium): from loss of consciousness to onset of automatic breathing. Eyelash reflex disappears but other reflexes remain intact and coughing, vomiting and struggling may occur ...
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]
General anesthetics elicit a state of general anesthesia. It remains somewhat controversial regarding how this state should be defined. [2] General anesthetics, however, typically elicit several key reversible effects: immobility, analgesia, amnesia, unconsciousness, and reduced autonomic responsiveness to noxious stimuli. [2] [3] [4]
Balanced anesthesia, ... providing analgesia, ... anesthetic which is used for balanced techniques has similarity with that which is used for standing sedation. [9]
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