Intravenous  (Conscious) Sedation

The average medical/surgical/dental patient, if given the choice, would prefer not to feel any pain and not to be aware of what was going on before, during, or after the surgery, and would prefer to have very little, if any, memory of the surgery.  As the numbers of minimally invasive outpatient/same day surgical procedures increased, it became obvious that the need for the ‘depth’ of general anesthesia that was achieved in an operating room setting of a hospital was not always required to accomplish the above stated objectives.  This could be done using a technique known as conscious sedation.  Using conscious sedation, one can obtain profound analgesia and sedation during the procedure which also produces retrograde amnesia (failure to remember events immediately before, during, and after the event.)  It is called ‘conscious’ because during the procedure the patient breaths on their own, maintains their own gag reflex, and is able to respond to verbal instructions given by the doctor or surgical staff; however, it is highly unlikely that the patient will remember any conversation that takes place while under sedation.

When is conscious sedation used?

Conscious sedation is routinely used for medical procedures such as cardiac cauterization, upper and lower gastrointestinal exams, dental procedures, and outpatient surgeries.

Are you conscious?

No.  When conscious sedation is used, the patient is aware of his or her surroundings but you don’t care much about them.  You are usually very sleepy, but can be awakened with touch or talking.  It is unlikely that you will remember the procedure after it is over because some medications given for conscious sedation cause short term amnesia.

Will I be hooked up to a lot of equipment?

Patients receiving conscious sedation will have their vital signs monitored by a cardiac monitor (3 lead EKG, blood pressure cuff, and pulse oximeter) which will be attached to them at all times.  This monitor will provide continuous data regarding the patient’s cardiac rhythm, heart rate, respiratory rate, blood oxygen saturation, blood pressure, and temperature.

Will I receive oxygen during the procedure?

If necessary, oxygen will be placed on the patient prior to sedation and may be left on the patient throughout the procedure.  

Will it take very long to recover from conscious sedation?

No.  Most of the time patients wake up very quickly after their procedure.  The patient is not allowed to drive home.  Judgment can be affected by medications and it is important for the patient to not drive, operate dangerous equipment, or sign any legal papers for 24 hours after receiving any medications for sedation.

References:

Acute Pain Management: Operative or Medical Procedures and Trauma. Clinical Practice Guidelines, 1992 DHHS Pub. No AHCPCR 92-0032. Arky, R, Medical Consultant.

1998 Physicians Desk Reference.  Medical Economics Company, Montevale, NJ.

Recommended Practices. Monitoring the Patient Receiving IV Conscious Sedation. AORN, April 1993, Vol.571, No.4.