UNDERSTANDING CONSCIOUS SEDATION
By Nicole Mongelli
As a patient at Nevada Advanced Pain Specialists, it might be recommended that you undergo a procedure to confirm the cause and/or help alleviate your chronic pain. Diagnostic procedures by insurance protocols must be done under local anesthesia with no sedation. Unfortunately, as a patient, you have no choice in these scenarios on your anesthesia care. Therapeutic procedures on the other hand, you and your provider may decide on what type of sedation is best for you. Your main options will be local anesthesia, local anesthesia with oral sedation, and local anesthesia with IV conscious sedation. Deep sedation and/or general anesthesia will only be options for surgical procedures.
Conscious sedation is a type of sedation that induces an altered state of consciousness to reduce pain and discomfort with a mixture of pain relievers and sedatives. Because it is more than just a local anesthetic, it cannot be performed in an office and will need to be done in a surgery center or hospital setting. Conscious sedation is achieved through an IV with a mixture of fentanyl and versed administered by your physician. Fentanyl Is a medication that helps with pain and versed helps with anxiety. The mixture of the two can cause anterograde amnesia, meaning you are less likely to remember what happens while it is in your system.
There are various levels of conscious sedation. Please see table below for an explanation of the different levels of conscious sedation.
Physicians typically aim for the least amount of sedation to get you through your procedure safely. The goal is moderate sedation since it is a safe option where patients can communicate with their physician during the procedure (if needed) and the patient is able to maintain their airway without any medical intervention. It is expected that you will be awake and be able to communicate with you physician during the procedure but you will feel relaxed, comfortable, and may or may not remember the experience. The surgery center and/or hospital also mandates that only moderate sedation be done for interventional pain procedures unless an anesthesiologist (second physician) is there to administer the anesthesia care. Deep sedation and/or general anesthesia can only be done by an anesthesiologist in the operating room for surgical procedures.
We encourage you to discuss this topic further with your provider if it is recommended you undergo a procedure for your condition. We are here to help you and educate you on your medical care. Overall, we want help alleviate any concerns or anxiety you might have before you undergo a procedure that can help your condition.