The Conscious Sedation Overview
The advent of anesthesia for
medical procedures has been one of the many advances in medicine. Pain is one
of the reasons people seek medical care, and it will be unreasonable if we, as
medical practitioners, cannot relieve patients’ pain during procedures.
Conscious sedation refers to using a combination of drugs to mildly depress the
central nervous system while leaving functions such as respiration and
cardiovascular functions intact
(Sidawy & Perler, 2018). In addition, the patient can respond to
commands and engage during the procedure. The term moderate sedation has recently
been used to describe conscious sedation. This type of anesthesia is used in
minor procedures, mostly dental, dermatological, and laser surgery for
Drugs for conscious sedation
require careful titration as an overdose could cause a critical depression that
may require invasive airways due to hypoventilation (Townsend et al., 2016). Some
of the drugs used include fentanyl, propofol, midazolam, which have known side
effects and are fatal when the dose is not titrated properly. This brings both
the anesthetist and the registered nurse to task in preparation for the patient
and getting ready in case of a complication. The patient’s history is taken,
and more emphasis is put on known allergies to any of the compounds in the
anesthesia drugs or experience of past sedation. The American Society of
Anesthesiologists has developed standard patient selection and classification
guidelines before sedation.
My experience of conscious sedation
was a female patient who had positive visual inspection under Lugol’s iodine
and a positive Papanicolaou smear. The patient was scheduled for a loop
electrosurgical excision procedure in the theatre. LEEP is a procedure done to
obtain a cervical biopsy for histology. During the procedure, the patient was
fully awake and could respond to commands. During the procedure, the patient
appeared sleepy but could still respond to commands. The patient’s blood
pressure, oxygen saturation, and respiration remained normal throughout the
procedure. The patient reported no pain or anxiety. The procedure lasted
fifteen minutes, and by the thirtieth minute, the effect of sedation had worn
off, and the patient could walk back to the general ward.
The nurse has a critical role in
the care of sedated patients preoperative, intraoperative, and postoperative. The
nurse prepares the patient for impending surgery in preoperative care by taking
anesthesia and allergies history. In intraoperative care, the nurse engages the
patient to check for the level of consciousness and the extent of central
nervous system depression Documentation and monitoring of vital signs is key
for detecting any deviations from normal. Lastly, postoperatively, the nurse’s
role is to monitor vital signs, documentation and should be prepared to respond
to any emergency.
Sidawy, A. P., & Perler, B. A.
(2018). Rutherford’s vascular surgery and endovascular therapy, E-Book.
Elsevier Health Sciences.
Townsend, C. M., Beauchamp, R. D., Evers, B.
M., & Mattox, K. L. (2016). Sabiston textbook of surgery E-book.
Elsevier Health Sciences.