Conscious sedation for surgical procedures

Definition

Conscious sedation is a combination of medicine to help you relax (a sedative) and another medicine to block pain (an anesthetic). You will probably stay awake and be able to respond to people during a medical or dental procedure. You should not need help with your breathing.

Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.

Alternative Names

Anesthesia - conscious

Description

A nurse, doctor, or dentist, will give you conscious sedation in the hospital or outpatient clinic. Most of the time, it will not be an anesthesiologist. The medicine will wear off quickly, so it is used for short, uncomplicated procedures.

You may receive the medicine through an intravenous line (IV, in a vein) or a shot into a muscle. You will begin to feel drowsy and relaxed very quickly. If your doctor gives you the medicine to swallow, you will feel the effects after about 30 to 60 minutes.

Your breathing will slow down, and your blood pressure may drop a little. Your nurse or doctor will monitor you every 3 to 5 minutes during your procedure to make sure you are okay. You may receive extra oxygen through a mask or IV fluids through a catheter (tube) into a vein.

You may fall asleep, but you will wake up easily to respond to people in the room. After conscious sedation, you may feel drowsy and not remember much about your procedure.

Why the Procedure Is Performed

Conscious sedation is safe and effective for patients who need minor surgery or a procedure to diagnose a condition.

Some of the tests and procedures conscious sedation is used for are:

• Breast biopsy
• Vasectomy
• Minor foot surgery
• Minor bone fracture repair
• Plastic or reconstructive surgery
• Dental prosthetic or reconstructive surgery
• Endoscopy (such as procedures to diagnose and treat some stomach, colon, and bladder conditions)

Risks

Conscious sedation is usually safe. However, if you are given too much of the medicine, problems with your breathing may occur. A doctor or nurse will be watching you during the whole procedure. Health care providers should have special equipment to help you with your breathing if needed.

Before the Procedure

Always tell your doctor or nurse:

• If you are or could be pregnant
• What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

During the days before your procedure:

• Tell your doctor about any allergies or health conditions you have, what medicines you are taking, and what anesthesia or sedation you have had before.
• You may have blood or urine tests and a physical exam.
• Arrange for a responsible adult to drive you to and from the hospital or clinic.
• If you smoke, try to stop. Ask your doctor or nurse for help quitting.

On the day of your procedure:

• You will usually be asked not to drink or eat anything after midnight the night before your procedure.
• Do not drink alcohol the night before and the day of your procedure.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital or clinic.

After the Procedure

After conscious sedation, you will feel sleepy and may have a headache or feel sick to your stomach. Your finger will be clipped to a special device (pulse oximeter) to check the oxygen levels in your blood. Your blood pressure will be checked with an arm cuff about every 15 minutes.

You should be able to go home 1 to 2 hours after your procedure.

When you are home:

• Eat a healthy meal to restore your energy.
• You should be able to return to your everyday activities the next day.
• Avoid driving, operating machinery, drinking alcohol, and making legal decisions for at least 24 hours.
• Check with your doctor before taking any medicines or herbal supplements.
• If you had surgery, follow your doctor’s instructions for recovery and wound care.

Outlook (Prognosis)

Conscious sedation is generally safe.

References

Jagannath S, Baron TH, Anderson MA, et al. Sedation and anesthesia in GI endoscopy. Gastrointestinal Endoscopy. Aug 2008;68(2).

Cohen NA, Stead SW. Moderate sedation for chest physicians. Chest. June 2008;133(6).

Sherwood ER, Williams CG, Prough DS. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 18.