This technique
involves the use of analgesic, sedative and the dissociative drugs to provide
sedation, analgesia and anesthetics,
anxiolysis, and motor control during unpleasant diagnostic and therapeutic
procedures. Progression from sedation to general anesthesia
does not cause an arbitrary division by itself. Sedative hypnotics and opioids
induce a mild sedation and analgesia along with the adverse events. Increase in
the dose provides sedation for a longer time and a high risk of airway and
respiratory distress.
The practice of
procedural sedation and analgesia has three sequences /methods: presedation assessment,
sedation for the procedure, and postprocedure recovery and discharge.
Sedation falls
under the following categories:
Minimal
Sedation: the state of anxiolysis, although having cognitive function and
coordination might be impaired, ventilatory and cardiological functions remain
unaffected.
Moderate
Sedation: A drug induced depression of consciousness having tactile
stimulation. The withdrawal of reflex from painful stimulus to maintain a
patent airway.
Dissociative
sedation: It is induced by drug like ketamine
which is characterized by profound amnesia and analgesia with the retention of airway
flexus, cardiopulmonary stability and spontaneous respirations.
Deep sedation:
Induced depression along with consciousness. The ability to independently
maintain ventilatory function could be impaired.
State of altered
consciousness resulting in euphoria, amnesia and relaxation. Moderate sedation
is a state of depression that is minimized by drugs allowing the protection for
reflexes is to be maintained. Patient independently regulates patient airway
and responds to the stimulation.
