Conscious Sedation: A Primer for Outpatient Procedures

any painful or anxiety-provoking procedures can be successfully performed in the outpatient setting with the aid of pharmacologic agents. The provision of procedural sedation can be safe and successful as long as the available pharmacologic agents and the various techniques of administration are well understood. However, patient safety must remain the primary concern. Most agents used for sedation and analgesia are capable of causing inadequate spontaneous respirations and may also impair the patent airway. Occasionally, attempts at outpatient sedation must be abandoned and formal, general anesthesia must be performed in order to successfully complete a procedure. It is wiser to apologize for some discomfort during a procedure, or halt a procedure altogether, than to risk anoxic brain injury during an otherwise minor procedure. This review focuses on the provision of sedation and analgesia by non-anesthesiologists for procedures outside the operating room. Various sedative agents and reversal agents are presented. Considerations related to specific procedures and patient age are also discussed. STANDARDS FOR ANESTHESIA CARE