Is conscious sedation pain relivers in surgeries?
Conscious sedation is a type of anesthesia used in minor surgeries and minimally-invasive procedures. Conscious sedation assists in making the application of local anesthesia even more comfortable and painless. The sedatives are administered intravenously through a small catheter (butterfly) placed in the arm by an anesthesiologist who can control and monitor the depth and duration of your relaxed, sleep-like state throughout. In special circumstances, the sedatives can be administered orally (in syrup) or via the nose (in drops). With conscious sedation, the effects wear off quickly after the procedure and ensure the patient is relaxed and at ease throughout the operation.
Conscious sedation Process
Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedure. You will probably stay awake, but may not be able to speak.
Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.
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 and your blood pressure may drop a little. Your health care provider will monitor you during the procedure to make sure you are OK. This provider will stay with you at all times during the procedure.
You should not need help with your breathing. But you may receive extra oxygen through a mask or IV fluids through a catheter (tube) into a vein.
Indications for Conscious Sedations
- Dental phobia and anxiety
- Traumatic and long dental procedures
- Medical conditions aggravated by stress such as angina, asthma, and epilepsy
- Children more than 1 year of age
- Mentally challenged individuals
- Ineffective local anesthesia due to any reason
Conscious sedation helps reduce anxiety, discomfort, and pain during certain procedures. This is accomplished with medications and (sometimes) local anesthesia to induce relaxation.
Conscious sedation is now usually referred to by medical professionals as procedural sedation and analgesia. In the past, it’s been called:
- sleep dentistry
- twilight sleep
- happy gas
- laughing gas
- happy air
Conscious sedation is known to be effective, but medical professionals still debate its safety and efficacy because of its effects on your breathing and heart rate.
Stages of Conscious Sedation
There are also three different stages of conscious sedation:
- Minimal (anxiolysis). You’re relaxed but fully conscious and responsive
- Moderate. You’re sleepy and may lose consciousness, but you’re still somewhat responsive
- Deep. You’ll fall asleep and be mostly unresponsive.
Procedures for conscious sedation
The steps for conscious sedation may differ based on the procedure you’re having done.
Here’s what you can typically expect for a general procedure using conscious sedation:
- You’ll sit in a chair or lie on a table. You may change into a hospital gown if you’re getting a colonoscopy or endoscopy. For an endoscopy, you’ll usually lie on your side.
- You’ll receive a sedative through one of the following: an oral tablet, an IV line, or a facial mask that lets you inhale the sedative.
- You’ll wait until the sedative takes effect. You may wait up to an hour before you begin to feel the effects. IV sedatives usually begin working in a few minutes or less, while oral sedatives metabolize in about 30 to 60 minutes.
- Your doctor monitors your breathing and your blood pressure. If your breathing becomes too shallow, you may need to wear an oxygen mask to keep your breathing consistent and your blood pressure at normal levels.
- Your doctor begins the procedure once the sedative takes effect. Depending on the procedure, you’ll be under sedation for as little as 15 to 30 minutes, or up to several hours for more complex procedures.
The drugs used in conscious sedation vary based on delivery method:
- Oral. You’ll swallow a tablet containing a drug like a diazepam (Valium) or triazolam (Halcion).
- Intramuscular. You’ll get a shot of benzodiazepine, such as midazolam (Versed), into a muscle, most likely in your upper arm or your butt.
- Intravenous. You’ll receive a line in an arm vein containing a benzodiazepine, such as midazolam (Versed) or Propofol (Diprivan).
- Inhalation. You’ll wear a facial mask to breathe in nitrous oxide.
Experience while Conscious Sedation
Sedation effects differ from person to person. The most common feelings are drowsiness and relaxation. Once the sedative takes effect, negative emotions, stress, or anxiety may also gradually disappear.
You may feel a tingling sensation throughout your body, especially in your arms, legs, hands, and feet. This may be accompanied by heaviness or sluggishness that makes it feel harder to lift or move your limbs.
You may find that the world around you slows down. Your reflexes are delayed, and you may respond or react more slowly to physical stimuli or conversation. You may even start smiling or laughing without an obvious cause. They call nitrous oxide laughing gas for a reason.
Side Effects of Sedation
Some common side effects of conscious sedation may last for a few hours after the procedure, including:
- feelings of heaviness or sluggishness
- loss of memory of what happened during the procedure (amnesia)
- slow reflexes
- low blood pressure
- feeling sick
Recovery from Conscious Sedation
Recovery from conscious sedation is pretty quick.
Here’s what to expect:
- You may need to stay in the procedure or operating room for up to an hour, maybe more. Your doctor or dentist will usually monitor your heart rate, breathing, and blood pressure until they’re back to normal.
- Bring a family member or friend who can drive or take you home. You can usually drive once some forms of sedation, such as nitrous oxide, wear off. However, this isn’t always the case for other forms.
- Some side effects may last for the rest of the day. These include drowsiness, headaches, nausea, and sluggishness.
- Take a day off work and avoid intense physical activity until side effects wear off. This is especially true if you plan to do any manual tasks that require precision or operate heavy machinery.