Educational Article

Procedural Sedation - December 2, 2016

In recent years, the use of noninvasive and minimally invasive procedures has grown dramatically. These procedures are often done in an outpatient setting and are conducted using techniques that include local and regional anesthesia and procedural sedation. Procedural sedation and analgesia (PSAA) is a technique of administering sedatives or dissociative agents, with or without analgesics, to induce a state that allows the patient to tolerate unpleasant procedures. Cardiorespiratory functions such as ventilation, oxygenation, and circulation are maintained through the procedure. This ensures the management of a patient’s pain and anxiety while facilitating the necessary procedural care in a safe and effective way.

The goals and benefits of using procedural sedation and analgesia include:

  • Patient safety
  • Minimal pain and anxiety
  • Minimal movement during the procedure
  • Maximizing the procedure’s success and return the patient to a presedation state quickly and safely

The anesthesiologists performing the procedure must have an extensive understanding of the medications administered and the skills necessary to manage any potential complications. Common medications used in PSAA include propofol, dexmedetomidine, ketamine, fentanyl, and midazolam. Generally, these medications have rapid onset and short duration of action. In knowledgeable hands, they allow for a patient’s safety, comfort, and rapid recovery. After a procedure using PSAA is finished, patients are monitored in a recovery setting until a safe discharge can be met.

Procedural sedation and analgesia is safe and effective when administered by trained anesthesia professionals. Each individual is different, so many factors weigh in the decision to use PSAA instead of other forms of anesthesia. If you are a candidate for PSAA during your next procedure, our physicians will discuss the risks and benefits for your specific situation.

National Institutes of Health
American College of Emergency Physicians