Guidelines for conscious sedation during non operative procedures
Ahmed Mokhtar Hassan khater;
Abstract
The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown dramatically over the last several decades.
Recently, more medically complex patients have been undergoing more procedures outside the operating room, due to technological advances in medicine, the increased proficiency of proceduralists and a raised awareness of healthcare costs. So, conscious sedation is the preferred practice for these procedures.
Conscious sedation is defined as a medically controlled state of depressed consciousness that allows protective reflexes to be maintained, retains the patient to maintain a patent airway independently and continuously and permits appropriate response of the patient to physical stimulation and verbal commands.
A wide variety of drugs are used to provide sedation and analgesia. The ideal drug should have a rapid onset of action with a predictable dose-effect relationship with respect to its sedative-hypnotic actions. Excitatory effects should be minimal as should be its respiratory and cardiovascular depressant effects.
Drugs commonly used are Benzodiazepines, propofol, ketamine, short acting barbiturates, chloral hydrate, short acting opioids, local anaesthetics. Adjuvant agents as anticholinergic, antihistaminics, and anti-emetics.
Procedures performed outside operating room have problems in common as distant location, long transport to PACU, Awkward position of patients, remote monitoring and lack of help.
Chapter XI Summary
Conscious sedation is provided in many suites such as gastrointestinal endoscopy, cardiac catheterization, cardioversion, radiology suites, dental suites and emergency department.
Monitoring of patients receiving conscious sedation include respiratory monitoring by pulse oximetry and capnography. Cardiovascular system is monitored by arterial pulse arterial-blood pressure and ECG. Temperature monitoring to prevent hypothermia and shivering which may be uncomfortable to the patient, this is achieved by a thermometer applied in the axilla as rectal or nasopharyngeal probes are impractical. C.N.S. monitoring by careful
Recently, more medically complex patients have been undergoing more procedures outside the operating room, due to technological advances in medicine, the increased proficiency of proceduralists and a raised awareness of healthcare costs. So, conscious sedation is the preferred practice for these procedures.
Conscious sedation is defined as a medically controlled state of depressed consciousness that allows protective reflexes to be maintained, retains the patient to maintain a patent airway independently and continuously and permits appropriate response of the patient to physical stimulation and verbal commands.
A wide variety of drugs are used to provide sedation and analgesia. The ideal drug should have a rapid onset of action with a predictable dose-effect relationship with respect to its sedative-hypnotic actions. Excitatory effects should be minimal as should be its respiratory and cardiovascular depressant effects.
Drugs commonly used are Benzodiazepines, propofol, ketamine, short acting barbiturates, chloral hydrate, short acting opioids, local anaesthetics. Adjuvant agents as anticholinergic, antihistaminics, and anti-emetics.
Procedures performed outside operating room have problems in common as distant location, long transport to PACU, Awkward position of patients, remote monitoring and lack of help.
Chapter XI Summary
Conscious sedation is provided in many suites such as gastrointestinal endoscopy, cardiac catheterization, cardioversion, radiology suites, dental suites and emergency department.
Monitoring of patients receiving conscious sedation include respiratory monitoring by pulse oximetry and capnography. Cardiovascular system is monitored by arterial pulse arterial-blood pressure and ECG. Temperature monitoring to prevent hypothermia and shivering which may be uncomfortable to the patient, this is achieved by a thermometer applied in the axilla as rectal or nasopharyngeal probes are impractical. C.N.S. monitoring by careful
Other data
| Title | Guidelines for conscious sedation during non operative procedures | Other Titles | المبادئ التوجيهية للتهدئة مع اليقظة خارج غرفة العمليات | Authors | Ahmed Mokhtar Hassan khater | Issue Date | 2014 |
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