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Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own.
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane , diethyl ether , propofol , etomidate , ketamine , pentobarbital , lorazepam and midazolam .
It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.
Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia, premedication before surgical anesthesia, and procedural sedation, and to treat severe agitation. [12] It induces sleepiness, decreases anxiety, and causes anterograde amnesia. [12]
Dexmedetomidine, sold under the brand name Precedex among others, is a medication used for sedation. [4] Veterinarians use dexmedetomidine for similar purposes in treating cats, dogs, and horses. [10] [11] It is also used in humans to treat acute agitation associated with schizophrenia or bipolar disorder. [5]
The most common side effects for procedural sedation include low blood pressure, high blood pressure, diastolic hypertension, systolic hypertension, low blood oxygen level, and diastolic hypotension. [5] [6] Remimazolam was approved for medical use in the United States in July 2020, [5] [6] and in the European Union in March 2021. [3]
It has been commonly used to induce deep sedation or general anesthesia for surgery and dental procedures. Unlike many other barbiturates, methohexital actually lowers the seizure threshold, a property that makes it particularly useful when anesthesia is provided for an electroconvulsive therapy (ECT). [ 4 ]
Introduction: give brief overview of what procedural sedation is. Can utilize the ASA chart. Will also considering adding the medical uses to this. Process: talk through what happens with procedural sedation Agents: explain medications used by class. complications: discuss potential complications of this type of sedation and to individual ...