TAKE CARE OF YOUR HEALTH:
PROCEDURAL SEDATION IS A GROWING FIELD AND THESOCIETY OF SEDATION PRACTITIONERS OF SOUTH AFRICA – SOSPOSA- BRINGS YOU THE LATEST INFORMATION.
WHAT IS SEDATION?
When a patient is seen by his doctor or dentist and must undergo a surgical procedure then there are the following options available to make the patient comfortable/relaxed
- Local anesthesia
- Behavioral management techniques
- General anesthesia
- Procedural sedation
Medical professionals now have many options to ensure for that their patients experience as little discomfort as possible during invasive diagnostic or surgical procedures.
Sedation is a common form of pain and anxiety control during these procedures that make the patient feel more relaxed and sleepier. Because a lot of attention is given to pain control you will be put into a level of sedation that is needed for the specific procedure. From the patient’s vantage he will be very sleepy with virtually no memory of the procedure but most of all, the work will be done with no pain or very little discomfort.
TYPES OF SEDATION?
Light sedation, also known as monitored anaesthesia care, conscious sedation, or twilight sedation, is typically used for minor surgeries or shorter, less complex procedures. It is used when a local anaesthetic injection is insufficient, but deeper general anaesthesia is not required. Some procedures may necessitate taking certain types of biopsies or inserting a scope into the throat or colon to diagnose and treat medical diseases such as cancer.
An analgesic is a pain reliever that is frequently combined with sedatives. Procedures requiring sedation and painkillers can be performed in a hospital or an outpatient setting, such as a same-day surgical centre, doctor’s, or dentist’s office.
Procedural sedation is the next level of sedation, where the patient is a little bit deeper. However, all his reflexes, like breathing, coughing and response to stimuli, are still working and protecting his body. A range of aesthetic procedures, maxillofacial procedures, and cancer treatment procedures can be done under this level of sedation.
Lastly, there is deep sedation, the level of consciousness one step lighter than general anaesthesia, which is used in hospital theatres for procedures that require a deep level of sedation. This level of sedation falls outside of the scope of procedural sedation.
SURGICAL PROCEDURES PERFORMED UNDER CONSCIOUS SEDATION?
During a medical or dental operation, you may be given a combination of medications to create a conscious level known as sedation. These medications include a sedative, which helps you relax and or a small dose of an anaesthetic, which blocks discomfort and pain medications. You will most likely remain awake for light sedation and gradually sleepier depending on the level of sedation administered and monitored by the sedationist. As a result, you will lose progressively more of your ability to communicate with others at deeper levels.
Speedy recovery and rapid return to regular activities can be achieved with sedation during medical procedures.
A doctor or dentist will provide light sedation when you are in the hospital or an outpatient clinic for a minor procedure. It is not likely to be an anaesthesiologist in these cases. Since the effects of the medication won’t last long, it’s only appropriate for brief, uncomplicated treatments. If the level of sedation required, however, is more profound, a specially trained sedationist, often a qualified specialist anaesthetist, will administer the sedation.
The sedation practitioner can decide to give premedication as a tablet, liquid or injection. After around thirty to sixty minutes, you should start to feel the effects of the drug that your doctor prescribed for you.
Then the sedation process is initiated. You could get the medication by an intravenous line (also known as an IV, inserted into a vein) or with an injection directly into a muscle. Some very light sedation might require a bit of laughing gas ( Nitrous oxide). You will start to feel sleepy and calm shortly after taking the medication.
Your blood pressure may decrease a little while your breathing will become shallower. During the process, your doctor or another medical professional will monitor you to ensure everything goes smoothly. Monitoring your safety is critical; for simple conscious sedation, just physical monitoring is sufficient; for a deeper level, very sophisticated monitoring is routinely used. During the entire process, this healthcare professional will always remain near you.
No matter the level of sedation, you shouldn’t require assistance with breathing. That said, occasionally, you might be given additional oxygen via a mask or intravenous fluids via a drip inserted into a vein in your arm.
You will nod off, but you’ll be able to snap out of it quickly enough, especially in the more common lighter levels of sedation; you can reply to the other people in the room during conscious sedation but with more difficulty during procedural sedation. You can react appropriately to vocal prompts. You might feel sleepy after conscious sedation, and you probably will not remember much about the surgery you just had. People are expected to remember nothing of the procedure under procedural sedation.
The reasons for carrying out the procedure
People who require only a very modest operation or a diagnostic procedure are good candidates for light sedation since it is safe and effective.
Light and procedural sedation may be used for a variety of diagnostic and therapeutic procedures, including the following:
- A biopsy of the breast
- Surgical procedures involving dental prosthetics or reconstruction
- Repair of several minor bone fractures
- A brief operation on the foot
- Minor skin surgery
- Surgical procedures of a cosmetic or reconstructive nature
- Procedures to diagnose and treat some stomach (upper endoscopy), colon (colonoscopy), lung (bronchoscopy), and bladder (cystoscopy) problems
- Sedation procedures that are now possible are increasing so fast that this list is nowhere near complete