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Anesthesia and Sedation

Article information

J Korean Med Assoc. 2007;50(12):1065-1071
Publication date (electronic) : 2007 December 31
doi : https://doi.org/10.5124/jkma.2007.50.12.1065
Hae Ja Lim, MD
Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Korea. drlimhj@korea.ac.kr

Abstract

Anesthetic care is usually provided for patients undergoing surgical procedures to make them unconscious and painless during surgery. Nowadays there are increasing therapeutic or diagnostic procedures performed outside operating room. Sedation is more frequently provided as healthcare during procedures for patient's comfort and safety by non-anesthesiologist or anesthesiologist. Early in 1999, ASA (the American Society of Anesthesiologists defined "sedation and analgesia" and established 4 states: minimal sedation, moderate sedation, deep sedation, and general anesthesia. Monitored anesthetic care implies the potential for a deep sedation and is always administered by an anesthesiologist. It is not always possible to predict how an individual patient will respond by nature of being a continuum of sedation. Hence, practitioners intending to induce a given level of sedation should be able to rescue patients whose level of sedation becomes deeper than initially intended. The standards for preoperative evaluation, intraoperative monitoring, anesthetic care, etc. are not different from those for general anesthesia.

Keywords: Sedation; Anesthesia; Sedation / analgesia; Monitored anesthesia care

References

1. American Society of Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 1996. 84459–471.
2. American Society of Anesthesiologists, Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002. 961004–1017.
3. Hiller SC. In : Barash PG, Gullen BF, Stoelting RK, eds. Monitored anesthesia care Clinical anesthesia. Clinical anesthesia 2001. 4th edth ed. Philadelphia: Lippincot Williams & Wilkins; 1239–1254.
4. Epstein BS. The american society of anesthesiologists efforts in developing guidelines for sedation and analgesia for non-anesthesiologist. Anesthesiology 2003. 981261–1268.
5. Kim ST. KSIVA. Anesthesiologist-controlled sedation and patient-controlled sedation. Sedation 2004. Seoul: Eui-Hak Publishing & Printing; 19–29.
6. Irwin MG, Thompson N, Kenny NC. Patient-maintained propofol sedation. Anaesthesa 1997. 52525–530.
7. Newson C, Joshi GP, Victory R, White PF. Comparison of propofol administration techniques for sedation during monitored anesthesia care. Anesth Analg 1995. 81486–491.
8. Leslie K, Absalom A, Kenny GN. Closed loop control of sedation for colonoscopy using bispectral index. Anesthesia 2002. 57693–697.
9. Milne SE, Kenny GNC. Future applications for TCI systems. Anesthesia 1998. 53S. 56–60.
10. Saunders BP, Fukumoto M, Halligan S, Masaki T, Love S, Williams CB. Patient-administered nitrous oxide/oxygen inhalation provides effective sedation and analgesia for colonoscopy. Gastrointest Endosc 1994. 40418–421.
11. Oei-Lim VLB, Kalkman CI, Makkes PC, Ooms WG. Patient-controlled versus anesthesiologist-controlled conscious sedation with propofol for dental treatment in anxious patients. Anesth Analg 1998. 86967–972.
12. Herrick IA, Gelb AW, Tseng PS, Kirkby J. Patient-controlled sedation using propofol during interventional neuroradiologic procedures. J Neurosurg Anesthesiol 1997. 9237–241.
13. Cook LB, Lockwood GG, Moore CM, Whitwarm JG. True patient-controlled sedation. Anaesthesia 1993. 481039–1044.
14. Rudkin GE, Osborne GA, Finn BP, Jarvis DA, Vickers D. Intraoperative patient-controlled sedation. Comparison of patientcontrolled propofol with patient-controlled midazolam. Anaesthesia 1992. 47376–381.
15. White PF, Negus JB. Sedative infusions during local and regional anesthesia: A comparison of midazolam and propofol. J Clin Anesth 1991. 332–39.

Article information Continued

Copyright © 2007 Korean Medical Association

Table 1

Continuum of depth of sedation: Definition of general anesthesia and levels of sedation / analgesia

Table 1