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The American Society of Anesthesiologists defines the continuum of sedation as follows: [9] Minimal sedation – normal response to verbal stimuli. Moderate sedation – purposeful response to verbal/tactile stimulation. (This is usually referred to as "conscious sedation") Deep sedation – purposeful response to repeated or painful stimulation.
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.
It is however mostly used in mechanically ventilated patients in order to avoid over and under-sedation. Obtaining a RASS score is the first step in administering the Confusion Assessment Method in the ICU (CAM-ICU), [4] a tool to detect delirium in intensive care unit patients. The RASS is one of many sedation scales used in medicine.
Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness. Regional and local anesthesia block transmission of nerve impulses from a specific part of the body. Depending on the situation, this may be used either on its own (in which case the ...
The level of sedation via palliative sedation may be mild, intermediate or deep and the medications may be administered intermittently or continuously. [ 6 ] The term "refractory symptoms" is defined as symptoms that cannot be controlled despite the use of extensive therapeutic resources, with such symptoms having an intolerable effect on the ...
Inhalation sedation with nitrous oxide/oxygen is a well recognised safe and effective technique. The desirable effect of the procedure is to relax the patient while maintaining verbal contact. Compared to other sedation agents, it causes minimal physiological stress to the patient and risk of loss of consciousness is less likely.
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.