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Procedural Sedation - Levels of Sedation

Minimal Sedation

A drug-induced state during which patients respond normally to verbal commands, and respiratory and cardiovascular function is unaffected. The aim is to achieve anxiolysis for procedures during which pain is controlled by local or regional anaesthesia (e.g. lumbar puncture, abscess incision and drainage).

Moderate Sedation/ Conscious Sedation

A drug-induced depression of consciousness, or dissociation, during which patients respond purposefully to verbal commands +/- light tactile stimulation. Reflex withdrawal from a painful stimulus is NOT considered a purposeful response. This depth of sedation tends to be used for procedures that require muscular relaxation and analgesia (e.g. shoulder reduction of DC cardioversion).

Deep Sedation

A drug-induced depression of consciousness during which patients cannot be easily aroused, but respond purposefully following repeated or painful stimulation. Reflex withdrawal from a painful stimulus is NOT considered a purposeful response. This level of sedation tends to be reserved for painful procedures requiring muscular relaxation with minimal patient recoil (e.g. Hip relocation).

General Anesthesia

A drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilator function is often impaired.

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