Patient-controlled sedation with propofol/remifentanil yields superior facility in sedation and recovery time compared with midazolam/fentanyl when used in an appropriate care setting. Wang et al compared cardiorespiratory function and sedative and analgesic effects, using combinations of midazolam with either fentanyl or propofol in a non-randomized group of 480 patients undergoing colonoscopy procedures. The combination of midazolam with either fentanyl or propofol allowed patients to undergo colonosc
Propofol is a respiratory and cardiovascular depressant these effects have limited its use in the ED in the past, but it has become very popular, particularly for deep procedural sedation.It has been studied in fracture dislocation, incision and drainage, and cardioversion.Propofol can be used in the ED a sedative for short-term procedures, starting with 1 mg/kg and titrating to effect in increments of 0.5 mg/kg in adults.This also is a very good agent for sedation in patients receiving under these circu
For minimal and moderate sedation, a minimum of pulse oximetry is strongly recommended. In addition, continuous monitoring of the heart rate and respiratory rate and intermittent noninvasive blood pressure measurements are recommended by most. If intravenous access is not otherwise established, it is not required but should be carefully considered.Because the patient is not eating or drinking during this period, death would be caused by either the underlying disease or a known but unintended side effect of
There are four general categories of anesthesia commonly used for imaging procedures, including: local anesthesia, regional anesthesia, general monitored anesthesia care, and non-drug adjuncts.Sedatives or anesthesia may be offered to:
If anesthesia or sedation is required during pregnancy, efforts are made to avoid the of medications that could adversely affect the mother or unborn baby. Women who worry whether surgery and anesthesia are safe during pregnancy should consult their obstetrician, surgeon and anesthesiologist.Some patients, both adults and children, may not achieve adequate sedation and pain relief with sedative administration and may require a procedure to be rescheduled with general anesthesia.
Oxygen supplementation does correct hypoxia due to hypoventilation, and must be provided in all patients receiving sedation with LA or RA. However, if oxygen is not provided, or if oxygen supplementation is stopped either when the procedure is completed or when the patient is shifted to the ward, persistent, undiagnosed and untreated hypoventilation can lead to life-threatening hypoxia and cardiac arrest.“Every patient shall be monitored in the post-operative recovery area with continuous monitoring