All things Sedation.

Between awake and asleep

Sedation is a spectrum. Light sedation (also referred to as conscious sedation) leaves you relaxed but easily rousable; deep sedation has you almost entirely asleep and unaware. I titrate it to your procedure and to you, so you get exactly as much as you need and no more.

There are different points along the "sedation spectrum". The objective is to allow you to continue breathing on your own despite sedation, without the help of a breathing machine etc:

Conscious Sedation

With conscious sedation, your level of awareness is reduced, but you are usually still able to respond when spoken to or gently touched. Many patients feel pleasantly drowsy and may recall little or nothing about the procedure.

Sedation is usually given through a small cannula placed into a vein. Medications may include a sedative, such as midazolam, to help you relax, and pain-relieving medication, such as fentanyl, to reduce discomfort. The medications and doses are carefully selected for you, taking into account your health, the procedure and the level of sedation required.

Examples of procedures that are done under light or conscious sedation:

• minor dental
• minor eye surgery eg cataract surgery

Deep Sedation

For some procedures, deep sedation may be more appropriate. During deep sedation, you are usually asleep and are unlikely to be aware of the procedure. Because deeper sedation can affect breathing, blood pressure and heart function, your anaesthetist will remain with you throughout the procedure, closely monitoring you and adjusting the anaesthetic medications as needed. Specialist anaesthetists are trained to anticipate, prevent and manage any changes that may occur during sedation. Their focus is to keep you safe, comfortable and well cared for from the beginning of your procedure until you are awake and recovering. Examples of procedures done under deep sedation: - Gastroscopy / Endoscopy / Colonoscopy / Endoscopic Ultrasound - Chronic Pain procedures e.g. for rhizotomy procedures - Some urological procedures e.g. TPPB

What you'll notice

Most people recall little or nothing of the procedure itself. You feel calm and drowsy, time passes quickly, and you keep breathing on your own throughout while I monitor you closely. Sometimes in between doing a gastroscopy and colonoscopy, a short period of allowing you to wake occurs. Do not be worried if you have a faint recollection of music playing in the background or the staff speaking, this can be a totally normal feature of sedation procedures!

Recovery

Sedation usually wears off faster than a general anaesthetic, but it still affects your judgement for the rest of the day. You'll need someone to take you home, and you shouldn't drive, sign documents or care for others until the next day.