Sedation

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List of terms related to Sedation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Sedation is a medical procedure involving the administration of sedative drugs, generally to facilitate a medical procedure with local anaesthesia.

Uses

Sedation is typically used in procedures such as endoscopy, vasectomy, or minor surgery and in dentistry for reconstructive surgery, some cosmetic surgeries, removal of impacted wisdom teeth, or for high-anxiety patients. Sedation methods in dentistry include inhalation sedation (using nitrous oxide), oral sedation, and intravenous (IV) sedation. Inhalation sedation is also sometimes referred to as Relative Analgesia.

Sedation is also used extensively in the intensive care unit so that patients who are being ventilated tolerate having an endotracheal tube in their trachea.

Risks

Airway obstruction, apnoea and hypotension are not uncommon during sedation and require the presence of health professionals who are suitably trained to detect and manage these problems.

Causes

• Drug side effect:
  • Butorphanol
  • Carbinoxamine
  • Clobazam
  • Diphenhydramine
  • Hydrocodone bitartrate and acetaminophen
  • Metyrapone
  • Metirosine
  • Nabilone
  • Oxaprozin
  • Papaverine
  • Sodium oxybate

Levels of sedation

Sedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death). Typically, levels are (i) agitation, (ii) calm, (iii) responsive to voice only, (iv) responsive to shaking only, (v) responsive to pain only, and (vi) not responsive.

Examples of sedation scales include: MSAT (Minnesota Sedation Assessment Tool) and the Ramsay Scale (Ramsay, et al. 1974)

See also

• Terminal sedation
• Postprandial sedation

External links

• Sedation in the Emergency Room - Article by Steven Conrad, MD
• IV Sedation and Dentistry
• Oral Sedation and Dentistry
• Dr.A's Dental Journal - Do Anxious Dental Patients Really Need Oral Sedation?
• Sedation: What to expect
• Conscious sedation in dentistry in the UK