Procedural Sedation Flashcards
Minimal Sedation is AKA.
Anxiolysis
Minimally depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and respond normally to tactile and verbal command.
Minimal sedation
Moderate sedation is AKA
Conscious sedation
A depression of consciousness in which patients respond purposefully to verbal commands either alone or accompanied by light tactile stimulation.
No interventions are needed to maintain a patent airway and spontaneous ventilation is adequate.
Conscious sedation
Patients cannot be easily aroused but respond after repeated or painful stimulation.
May need help maintaining an airway.
CV is usually maintained.
Deep sedation.
Patients are not arousable, even by painful stimulation.
Can’t maintain airway or CV on their own.
General anesthesia.
These types of sedation are used for procedural sedation an analgesia.
Minimal (anxiolysis) and moderate (conscious sedation) sedation.
The measurement of CO2 in the air you breathe out.
Capnography
Standard of care for all levels of office-based anesthesia or sedation.
Capnography
T/F: Capnography is always done when a patient is under procedural sedation.
True
Properties of ________:
Anxiolysis
Sedation
Amnesia
BZD’s
Properties of _____:
Analgesia
Drowsiness
Sedation
Opioids
Most common IV SEDATION
Fentanyl + Midazolam
BDZ with the shortest duration of action and most commonly used in procedural sedation anesthesia.
Midazolam
BDZ MOA
Allosteric modulation at GABA-A receptor to increase GABA binding.
Pregnancy Category of Midazolam
D
Midazolam side effects
Behavioral changes
Nausea
Vomiting
Most commonly used inhaled anesthetics.
Nitrous and Sevoflurane
Has the lowest blood: gas partition coefficient, so it has the fastest onset of all inhalation anesthetics.
Nitrous
How are blood:gas partition coefficients related?
The lower the blood:gas partition coefficient, the faster the onset.
T/F: At doses typically provided by dental sedation units (0.1-0.5 MAC), respiratory and CV functions are minimally affected.
True
T/f: Low solubility of sevoflurane (and NO) facilitates rapid induction and elimination via the lungs following discontinuation of anesthesia).
True
Commonly used for intravenous GENERAL anesthesia
Propofol and Ketamine
Causes dissociative anesthesia.
Ketamine
Most commonly used IV anesthetic
Propofol
Anesthesia for wisdom teeth extraction usually include the following:
BDZ like Medazolam
Narcotic like fenatnyl or meperidine
Hypnotic drug like propofol, ketamine or methohexital.
Local anesthetics, and may also supplement IV sedation with inhaled nitrous.
What’s the advantage of using BDZ’s and opioids?
BDZ’s have Flumazenil antagonist if there’s an overdose.
Opioids have Naloxone if there’s an overdose.
Opioids provide _____.
analgesia
