Nobody likes pain and today there are many types of anesthesia available to help you feel comfortable during medical tests and procedures. One common type of pain control is called sedation, which relaxes you and sometimes makes you fall asleep. Sedation, also known as monitored anesthesia care, conscious sedation or twilight sedation, typically is used for minor surgeries or shorter, less complex procedures, such as biopsies, or the use of a scope to examine the throat or colon, to diagnose or treat medical conditions. Analgesia is used to provide pain relief.

What is Sedation and Analgesia?

Sedation and analgesia medications usually are provided through an IV placed in a vein. Depending on the procedure, the level of sedation may range from minimal — you’ll feel drowsy but able to talk — to deep, meaning you probably won’t remember the procedure. But even with deep sedation, you won’t actually be unconscious as you would be with general anesthesia. The analgesia medications may also contribute to your drowsiness.

Most patients wake up quickly once the procedure is over and the medications are stopped. Possible side effects include headache, nausea and drowsiness, but you likely will have fewer effects than you would from general anesthesia, and you’ll probably recover faster. Moderate or deep sedation may slow your breathing and in some cases you may be given oxygen.

Sometimes IV sedation and analgesia will be combined with another type of pain control, such as local anesthesia, which involves one or more injections to numb a small area of the body, or regional anesthesia, which numbs a larger part of the body, such as below the waist

IV sedation and analgesia can be provided for procedures that take place in the hospital, at an outpatient surgery center, a doctor’s office or a dentist’s office.

Who Provides Sedation?

A physician anesthesiologist, a medical doctor specializing in anesthesia, pain and critical care medicine, or a registered nurse or nurse anesthetist working with a qualified physician, can administer sedation. With 12 to 14 years of education and 12,000 to 16,000 hours of clinical training, physician anesthesiologists are highly trained medical specialists that help ensure safe, high-quality care.

Before you receive IV sedation and analgesia, you want to ask a few questions:

• Who will be responsible for administering the sedation and what are the healthcare provider’s qualifications?
• How will you be monitored during and after the procedure and by whom?
• What level of sedation will be used (minimal, moderate or deep)?
• What kind of equipment and personnel are available in case of an emergency?

How Should You Prepare for a Procedure with Sedation?

Don’t eat or drink — Usually you will be asked not eat or drink anything after midnight the day before your procedure. Ask the facility or your physician anesthesiologist for guidance. In some cases, you may able to drink clear liquids.

Levels of sedation
Minimal — While minimal sedation will help you relax, you likely will be awake. You’ll understand questions your doctor is asking and be able to answer as well as follow directions.
Moderate — You will feel drowsy and may even fall asleep during the procedure. You may or may not remember some of the procedure.
Deep — You won’t actually be unconscious, but you’ll sleep through the procedure and probably will have little or no memory of it.

Ask your physician which medications you should take before your procedure — There are some medications you should continue and others that you should not take.

Bring a friend or relative — You most likely will be woozy or weak and won’t be able to drive, so be sure someone is available to take you home after your procedure.

Wear comfortable clothing — You may be sore from the surgery or have bandages that cover incisions so wear clothes that are comfortable and loose.

Plan for recovery time — You probably will be moved to a recovery room after your procedure where your breathing and heart function will be monitored. In most cases you will be able to go home soon after the procedure, usually within one hour, perhaps longer if you have moderate or deep sedation. Consider having someone stay with you the first 24 hours after you return home, and plan to rest. You might also be told not to drive or drink alcohol for a day, especially if you are taking pain medication. Delay making any important decisions for a day or two as well.

Be prepared for side effects — You may have soreness or pain and possibly feel a little nauseated after surgery. Pain medication will be prescribed if you have pain from the procedure.

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