Procedural Sedation

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 it 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 help your healthcare provider treat you. For example, having a broken bone fixed may be easier if you feel relaxed.

This type of sedation is used only for short, basic procedures. It's not used for complex surgery. Some procedures that use this type of sedation include:

• Dental surgery

• 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 check for neurological disease

Risks of procedural sedation

Risks and possible side effects include:

• Headache

• Nausea and vomiting

• Bad memories of the procedure

• Slowed 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 and after your sedation. This is to help prevent problems.

Your own risks may vary. They can be 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 provider about how to get ready for your procedure. Tell them 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. This is to lessen the chance of a lung problem. Talk with your provider if you need help to stop smoking.

Tell your 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 could be

Also:

• Follow any directions you are given for not eating or drinking before procedure.

• Ask a trusted adult to take you home after the procedure. You can’t drive on the day you have sedation.

• Ask a trusted adult to stay with you for a few hours while you recover.

• Don't make any important decisions, such as financial or legal, on the day after you have sedation.

• Follow all other instructions from your provider.

During your procedural sedation

You may have your procedure in a hospital or a 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 get a shot or take it by mouth. Or you may inhale it through a mask.

• If you have 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 get a little extra oxygen. This is done through a mask or some soft plastic prongs under your nose.

• You will likely be awake the whole 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 start 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 go home within 1 to 2 hours after your procedure. Plan to have a trusted adult stay with you for a few hours. This person should make sure your condition is not getting worse. They should also watch for problems, and keep you safe. You may have side effects, such as nausea, fatigue, or unsteadiness for up to 24 hours. You may also feel lightheaded. Tell your healthcare provider if they continue.

Don’t drive or operate dangerous machines during the next 24 hours. Also, don't make any important business or personal decisions. And don't drink any alcohol during the next 24 hours. Take extra care when walking and moving, You may be at a higher risk of falling. Follow any instructions you were given for eating and drinking. Be sure to follow all after-care directions.

When to call your healthcare provider

Have someone call your healthcare provider right away if any of the following occur:

• Drowsiness that gets worse

• Weakness or dizziness that gets worse

• Repeated vomiting

• Your speech is slurred, and others cannot understand you

• Severe or ongoing pain from the procedure, not relieved by the pain medicine (if prescribed)

• Fever of 100.4º F (38°C) or higher, or as advised by your healthcare provider

• New rash

Call 911

Have someone call 911 if any of the following occur:

• Trouble breathing

• Trouble swallowing

• Chest pain

• Loss of consciousness or you can't be awakened