Sedation during regional anesthesia: inhalation versus intravenous

Current Opinion in Anaesthesiology
Lars E Helgeson

Abstract

Sedation of patients either with or without regional anesthesia is discussed to ascertain sedation requirements in the two groups. The differences between 'monitored anesthesia care' and conscious sedation are defined. Several current and promising methods with which we can evaluate a patient's degree or level of sedation are assessed. Also noted are safety concerns regarding monitoring solutions for patients undergoing monitored anesthesia care. Well established techniques, including some which are decidedly 'low tech', are examined. Several routes of intravenous administration are discussed along with patient variables. Sevoflurane sedation is mentioned with regards to administration, advantages and drawbacks. Several modalities have been studied for evaluation of a patient's level of sedation, some of which have little applicability in the operating room. Processed electroencephalographic monitoring has tremendous promise but is currently not reliable enough to assess sedation level. Sevoflurane has a role in sedation, providing the limitations are understood. One drawback of sevoflurane is its greater degree of disinhibition when compared with intravenous agents, necessitating conversion to general anesthesia. Evaluating th...Continue Reading

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Citations

Jun 30, 2011·Indian Journal of Anaesthesia·Sukhminder Jit Singh BajwaSps Goraya
Jun 9, 2016·Journal of Anaesthesiology, Clinical Pharmacology·Safiya I Shaikh, Sarala B Mahesh

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