Procedural sedation is medicine to ease discomfort, pain, and anxiety during a procedure. The medicine is often given through an IV (intravenous) line in your arm or hand. In some cases, the medicine may be taken by mouth or inhaled. While you are under sedation, you will likely be awake. But you may not remember anything afterward.
Why procedural sedation is used
Sedation is used for many types of procedures. The goal is to reduce pain, anxiety, and stressful memories of a procedure. It can also help your healthcare provider treat you. For example, having a broken bone fixed may be easier if you feel relaxed.
Procedural sedation is used only for short, basic procedures. It is not used for complex surgeries. Some procedures that use this type of sedation include:
Breast biopsy, to take a sample of breast tissue
Endoscopy, to look at gastrointestinal problems
Bronchoscopy, to check for lung problems
Bone or joint realignment, to fix a broken bone or dislocated joint
Minor foot or skin surgery
Electrical cardioversion, to restore a normal heart rhythm
Lumbar puncture, to assess neurological disease
Risks of procedural sedation
Procedural sedation has some risks and possible side effects, such as:
Nausea and vomiting
Unpleasant memory of the procedure
Lowered rate of breathing
Changes in heart rate and blood pressure (rare)
Inhalation of stomach contents into your lungs (rare)
Side effects will likely go away shortly after the procedure. Your healthcare team will watch your heart rate and breathing during your sedation. This is to help prevent problems.
Your own risks may vary based on your age and your overall health. They also depend on the type of sedation you are given. Talk with your healthcare provider about the risks that apply most to you.
Getting ready for procedural sedation
Talk with your healthcare provider about how to get ready for your procedure. Tell him or her about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you should stop to lessen the chance of a lung issue. Talk with your healthcare provider if you need help to stop smoking.
Tell your healthcare provider if you:
Have had any problems in the past with sedation or anesthesia
Have had any recent changes in your health, such as an infection or fever
Are pregnant or think you may be pregnant
Also be sure to:
Ask a family member or friend to take you home after the procedure. You can’t drive on the day you receive sedation.
Not eat or drink after midnight the night before your procedure, if advised.
Not plan on making any important decisions, such as financial or legal, for the day after you receive the sedation.
Follow all other instructions from your healthcare provider.
During your procedural sedation
You may have your procedure in a hospital or a medical clinic. Sedation is done by a trained healthcare provider. In general, you can expect the following:
You will be given medicine through an IV line in your arm or hand. Or you may receive a shot. The medicine may also be given by mouth. Or you may inhale it through a mask.
If you receive medicine through an IV, you may feel the effects very quickly. You will start to feel relaxed and drowsy.
During the procedure, your heart rate, breathing, and blood pressure will be closely watched. Your breathing and blood pressure may decrease a little. But you will likely not need help with your breathing. You may receive a little extra oxygen through a mask or through some soft plastic prongs underneath your nose.
You will probably be awake the entire time. If you do fall asleep, you should be easy to wake up, if needed. You should feel little or no pain.
When your procedure is over, the sedative medicine will be stopped.
After your procedural sedation
You will begin to feel more awake and aware. But you will likely be drowsy for a while afterward. You will be closely watched as you become more alert. You may have a faint memory of the procedure. Or you may not remember it at all.
You should be able to return home within an hour or two after your procedure. Plan to have someone stay with you for a few hours. Side effects such as headache and nausea may go away quickly. Tell your healthcare provider if they continue.
Don’t drive or make any important decisions for at least 24 hours. Be sure to follow all after-care instructions.
When to call your healthcare provider
Have someone call your healthcare provider right away if you have any of these:
Drowsiness that gets worse
Weakness or dizziness that gets worse
You can’t be awakened
Severe or ongoing pain from the procedure, not relieved by the pain medicine
March 26, 2017
Procedural Sedation in Adults Outside the Operating Room. UpToDate.
Demuro, Jonas, MD,Fetterman, Anne, RN, BSN