Conscious Sedation

Conscious sedation induces an altered state of consciousness that minimizes pain and discomfort through the use of pain relievers and sedatives. Patients who receive conscious sedation usually are able to speak and respond to verbal cues throughout the procedure, communicating any discomfort they experience to the provider.

Conscious sedation provides a safe, effective option for patients undergoing minor surgeries or diagnostic procedures. The number and type of procedures that can be performed using conscious sedation have increased significantly as a result of new technology and state-of-the-art drugs.

Conscious sedation allows patients to recover quickly and resume normal daily activities in a short period of time. A brief period of amnesia may erase any memory of the procedure.

Administration

Conscious sedation is administered in hospitals and outpatient facilities (for example, ambulatory surgery centers and doctors’ offices) to facilitate procedures such as the following:

• Breast biopsy
• Vasectomy
• Minor foot surgery
• Minor bone fracture repair
• Plastic/reconstructive surgery
• Dental prosthetic/reconstructive surgery
• Endoscopy (examples: diagnostic studies and treatment of stomach, colon and bladder)

Conscious sedation is extremely safe when administered by qualified providers: Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, other physicians, dentists and oral surgeons. Specifically trained registered nurses may assist in the administration of conscious sedation.

Monitoring Conscious Sedation

Because patients can slip into a deep sleep, proper monitoring of conscious sedation is necessary. Healthcare providers monitor the patient’s heart rate, blood pressure, breathing, oxygen level and alertness throughout and after the procedure. It is important that the provider who monitors the patient receiving conscious sedation has no other responsibilities during the procedure and remains with the patient at all times during the procedure.

A qualified provider monitors the patient immediately following the procedure. Written postoperative care instructions should be given to the patient to take home. Patients should not drive a vehicle, operate dangerous equipment or make any important decisions for at least 24 hours after receiving conscious sedation. A follow-up phone call usually is made by the healthcare provider to check on the patient’s condition and answer any remaining questions.

Side Effects

A brief period of amnesia after the procedure may follow the administration of conscious sedation. Occasional side effects may include headache, hangover, nausea and vomiting or unpleasant memories of the surgical experience.

Questions to Ask about Conscious Sedation

Following is a list of questions patients should ask prior to the surgical or diagnostic procedure:

• Will a trained and skilled provider be dedicated to monitoring me during conscious sedation?
• Will my provider monitor my breathing, heart rate and blood pressure?
• Will oxygen be available and will the oxygen content of my blood be monitored?
• Are personnel trained to perform advanced cardiac life support?
• Is emergency resuscitation equipment available on-site and immediately accessible in case of an emergency?
• Will a trained and skilled provider stay with me during my recovery period and for how long?
• Should a friend or family member take me home?

Note: The above information was provided by the American Association of Nurse Anesthetists. For more information visit www.aana.com and www.apsf.org.