Procedural Sedation and Analgesia Its Implementation and Developments

Abstract

As a result of the exponential increase in the number of diagnostic and therapeutic procedures being performed in the last few decades, there is a great demand for sedation services, which cannot be met by anesthesiologists, because of a shortage of these specialists.It is important that continuous monitoring will be carried out by qualified medical trained personnel. Task shifting or reshuffling from physicians to non-medical health care personnel occurs facing shortages of physicians or a situation where a task normally performed by a physician is transferred to a health care professional with a different level of education and training. The aim of this thesis was to study and discuss the aspects of patient’s safety during moderate to deep procedural sedation and analgesia, as a risky medical procedure, for diagnostic or therapeutic interventions in clinical and office based procedures. Sedation and analgesia introduce an independent risk factor for morbidity and mortality in addition to the complex processes itself, which must be integrated into patient care planning. Sedation can be defined as a pharmacologically induced state of a reduced level of consciousness. In order to prevent and properly manage potential events, the depth of sedation and cardiorespiratory signs should be periodically and continuously monitored in all patients.It is important that continuous monitoring will be carried out by qualified medical trained personnel other than the treating physician. A safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained sedation professionals and suitable facilities. Additionally, appropriate selection and preparation of patients, a suitable sedative technique, individually tailored administration of sedatives and analgesics, adequate monitoring, and proper recovery of patients is essential.