Procedural sedation analgesia

Sheta, Saad A.
January 2010
Saudi Journal of Anaesthesia;Jan2010, Vol. 4 Issue 1, p11
Academic Journal
The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA). The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interventions. The goals of PSA in four different multidisciplinary practices namely; emergency, dentistry, radiology and gastrointestinal endoscopy are discussed in this review article. Some procedures are painful, others painless. Therefore, goals of PSA vary widely. Sedation management can range from minimal sedation, to the extent of minimal anesthesia. Procedural sedation in emergency department (ED) usually requires combinations of multiple agents to reach desired effects of analgesia plus anxiolysis. However, in dental practice, moderate sedation analgesia (known to the dentists as conscious sedation) is usually what is required. It is usually most effective with the combined use of local anesthesia. The mainstay of success for painless imaging is absolute immobility. Immobility can be achieved by deep sedation or minimal anesthesia. On the other hand, moderate sedation, deep sedation, minimal anesthesia and conventional general anesthesia can be all utilized for management of gastrointestinal endoscopy.


Related Articles

  • Tumescent liposuction is a kind, gentle technique. Nash, Karen // Cosmetic Surgery Times;Jun2002, Vol. 5 Issue 5, p24 

    Focuses on the effectivity of the tumescent liposuction. Advantages provided by liposuction; Characteristic of the approach for procedure efficiency; Limitation on the amount of fat removed during the surgery.

  • Powerful Persuasion. Hill, Suzette // Dermatology Times;Oct2003, Vol. 24 Issue 10, p54 

    Investigates the complication rate comparable to that of traditional liposuction performed with tumescent anesthesia in New Orleans, Louisiana. Number of power-liposuction treatments performed; Percent rate of complication; Inclusion of potential serious risk.

  • Cannula Does Double Duty. Guttman, Cheryl // Dermatology Times;Oct2003, Vol. 24 Issue 10, p60 

    Reports on the tumescent anesthesia infiltration that cuts liposuction costs in San Francisco, California. Indication in using infiltration cannula; Efficiency on fat removal; Range in price.

  • Tumescent Anesthesia: Lidocaine Dosing Dichotomy. De Jong, Rudolph H. // International Journal of Cosmetic Surgery & Aesthetic Dermatolog;Mar2002, Vol. 4 Issue 1, p3 

    Tumescent anesthesia with highly diluted lidocaine and epinephrine has transformed lipoplasty from bloody hospital surgery to a painless and virtually bloodless office-based procedure. The 10-fold or greater dilution of bottled commercial lidocaine has unearthed a latent subdermal drug storage...

  • Tumescent infiltration versus femoral nerve block for skin graft harvest--a prospective randomized study. Mathew, Jimmy; Varghese, S.; Jagadeesh, S. // Indian Journal of Plastic Surgery;Jul-Dec2005, Vol. 38 Issue 2, p110 

    In this prospective, randomized study, 60 patients requiring a single sheet of graft were randomized into 2 groups. Tumescent infiltration was used for anesthesia in one group and femoral nerve block in the other. The pain during administration of anesthesia, the time required for onset of...

  • Tumescent local anesthesia today: Has it been misused? Palkhivala, Alison // Cosmetic Surgery Times;Apr2005, Vol. 8 Issue 3, p14 

    Examines the use of tumescent local anesthesia in modern medical practice in the U.S. Contentions concerning the necessity to develop measures to guard patient safety; Impact of the modifications since its inception twenty years ago on its safety and efficacy; List of current uses for local...

  • Local Anesthesia Safe In DCR Surgery.  // Review of Ophthalmology;Aug2005, Vol. 12 Issue 8, p92 

    Discusses the findings of a study conducted in Turkey, which found that local anesthesia with intravenous sedation in external dacrocystorhinostomy is safe and comfortable when an appropriate anatomical approach to nerve blocks is performed correctly. Total number of patients who underwent...

  • Tumescent anesthesia use expands. Kuznar, Wayne // Dermatology Times;Aug2002, Vol. 23 Issue 8, p44 

    Focuses on the benefits of certain tumescent anesthesia in the U.S. Efficacy of using tumescence on dermabrasion; Advantages of using the procedure in hair transplantation; Improvement in hemostasis after large skin grafting.

  • Tumescent anaesthesia for post burn contracture release. Sharma, Rajeev // Indian Journal of Anaesthesia;Nov/Dec2010, Vol. 54 Issue 6, p579 

    A letter to the editor is presented in response to the article "Role of Ketamine in Fiberoptic Era," by Chand T. and colleagues.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics