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The most common standard conscious sedation technique for adults is intravenous sedation using Midazolam. This requires a needle to be put into a vein to deliver the medication; this is known as an IV cannula. [citation needed] Indications: [citation needed] Reduced dental anxiety and phobia; Traumatic or prolonged dental procedures
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.
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.
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.
TIVA is used to induce general anesthesia while avoiding the disadvantages of volatile anesthesia (and traditional inhalation agents). [9] Intravenous anesthetic agents are titrated at safe doses to maintain stage III surgical anesthesia (unconsciousness, amnesia, immobility, and absence of response to noxious stimulation). [10]
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).
Propofol for sedation for intubation; Switching from oxygen to a mixture of oxygen and inhalational anesthetic once intubation is complete; Laryngoscopy and intubation are both very stimulating. The process of induction blunts the response to these maneuvers while simultaneously inducing a near-coma state to prevent awareness.