What Is Sedation?

Sedation is an anesthetic technique that helps the patient relax, reduces anxiety and makes certain medical procedures more comfortable.

It is often described as "light anesthesia", "half asleep" or "anesthesia without being put to sleep", but none of these phrases explains it properly.

Sedation is not one single procedure.

It covers a wide range, from light sedation in which the patient is fully awake, to deep sedation that comes close to general anesthesia.

For this reason the boundary between sedation and general anesthesia can be less clear than people assume.

Why is sedation used?

Some procedures are not as major as surgery, yet they can still cause anxiety, fear or discomfort.

In these situations sedation improves the patient's comfort and allows the procedure to be carried out more safely and smoothly.

Procedures where sedation is commonly used include:

• Endoscopy
• Colonoscopy
• Bronchoscopy
• Interventional radiology procedures
• Some dental treatments
• Minor surgical procedures

For some patients it is not the procedure itself but the very idea of it that causes serious anxiety. Sedation helps with that too.

Does the patient sleep during sedation?

The answer depends on the depth of sedation.

Under light sedation the patient can communicate, answer questions and keeps breathing independently.

Under moderate sedation the patient becomes drowsier but can still be woken when needed.

Under deep sedation the patient responds much less to external stimuli, and the state can come close to general anesthesia.

This is why it is not accurate to think of sedation as a single procedure.

How does sedation differ from general anesthesia?

This is one of the questions patients ask most often.

Sedation and general anesthesia are not two separate boxes. They are different points on the same spectrum.

Under general anesthesia:

• Consciousness is switched off completely
• Awareness during surgery is eliminated
• More advanced airway management is usually required

With sedation, the aim is mostly relaxation, reduced anxiety and a more comfortable experience.

But deep sedation can approach general anesthesia closely.

This is why sedation, like general anesthesia, requires the knowledge and experience of an anesthesiologist.

Is pain felt during sedation?

The main purpose of sedation is relaxation and reduced anxiety.

Pain control is planned separately according to the procedure.

In some procedures local anesthesia is applied alongside sedation. In others, analgesic drugs are used.

So it is not correct to assume that sedation on its own means the absence of pain.

Can you breathe during sedation?

In most sedation procedures the patient keeps breathing independently.

However, breathing can be affected depending on the dose of the drugs and the patient's characteristics.

For this reason the following are monitored closely during sedation:

• Oxygen level
• Respiratory rate
• Heart rhythm
• Blood pressure

This is one of the reasons sedation should not be seen as "just giving a sedative".

Is sedation safe?

Sedation is an extremely common and safe procedure in modern medicine.

But the reason it is safe has less to do with the drugs than with proper assessment of the patient and continuous monitoring throughout.

Before sedation, the following are reviewed:

• Heart conditions
• Lung conditions
• Sleep apnea
• Current medication
• Previous anesthesia experiences

Because every patient responds differently, the plan is made individually.

Do you need to fast before sedation?

Yes.

A period of fasting is required before sedation as well, because the drugs used can affect the protective reflexes of the stomach.

If that happens, stomach contents can pass into the lungs.

The fasting period varies with the procedure and the patient, so it is important to follow the instructions you are given.

What can happen after sedation?

Most patients recover within a short time. Temporarily, however, the following may occur:

• Drowsiness
• A feeling of grogginess
• Reduced attention
• Mild dizziness
• Nausea

For this reason patients are generally advised not to drive on the same day.

Who might sedation not be suitable for?

Sedation can be given safely to most patients, but some situations call for a more detailed assessment. For example:

• People with advanced lung disease
• People with serious heart disease
• Patients with morbid obesity
• People with sleep apnea

This does not mean sedation cannot be given. It means the planning has to be more detailed.

Why sedation counts as anesthesia

Sedation is sometimes seen as "simply giving a sedative".

In fact the drugs used act directly on the level of consciousness, and they require continuous assessment of breathing, circulation and airway safety.

That is why sedation is one of the important practices of modern anesthesiology.

The difference between sedation and general anesthesia is often not the name of the drug, but the depth of the effect produced.