Q&A with John Jeffrey Andrews, M.D.
Chair of the ASA Committee on Patient Safety and Education: Sedation Analgesia
Q: What is sedation?
A: In general, sedation is a semiconscious state that allows patients to be comfortable during certain surgical or medical procedures. An anesthesiologist may be the physician administering the sedation. Anesthesiologists are physicians trained to administer all levels of sedation, including general anesthesia should it become necessary.
Q: How is sedation different than general anesthesia?
A: Sedation is a drug-induced state that is not as “deep” as general anesthesia. When possible, it is often used instead of general anesthesia because breathing and cardiac function are less affected, and patients generally recover faster after sedation than from general anesthesia.
Q: Are there different levels of sedation?
A: Yes. The effects of sedation are better described in terms of “stages” – part of a scale – but they can usually be divided into three categories:
Minimal sedation –The patient feels relaxed and may be awake. He or she can understand and answer questions and will be able to follow the physician’s instructions. Breathing and cardiovascular function are unchanged.
Moderate sedation – The patient feels drowsy and may even sleep through much of the procedure, but easily awakens when spoken to or touched. The patient may or may not remember being in the procedure room.
Deep sedation – The patient sleeps through the procedure with little or no memory of the procedure room. The patient may need help with breathing, and the patient may continue sleeping until the medication wears off.
Q: Will I feel pain?
A: Typically, when a patient undergoes a medical procedure for which he or she is sedated, the patient is often given sedation analgesia which will provide pain relief as well as relief of anxiety that may accompany some treatments, tests or procedures.
Q: How is it used? How will I receive sedation?
A: Sedation analgesia is usually administered through an IV to relax the patient and to minimize any discomfort that the patient might experience during the procedure. It can also be used in combination with a “numbing medicine” or local anesthetic.
Q: Is there going to be an anesthesiologist to monitor me throughout the sedation experience?
A: A medical professional will be on hand to monitor your vital signs (breathing, heart rate) while you are sedated. However, that person is not always an anesthesiologist. It is important to talk with your physician prior to the procedure to understand who is going to be treating you. You should ask about the level of the training the team has and who will be present to handle any situations during the procedure that might affect you.
Q: What does it feel like to go under anesthesia?
A: Going under anesthesia is an individual experience for everyone. There is no one feeling that describes the process.
Q: How long does it take for anesthesia to wear off?
A: The two most important factors that determine how rapidly anesthesia wears off are (1) the duration of the procedure and (2) the types of drugs used. For short procedures using short-acting drugs, anesthesia wears off rapidly. For long procedures using long-acting drugs, anesthesia wears off more slowly.
Q: What happens after the procedure? Will I still be sedated?
A: Patients spend time in a recovery room where they will be monitored until the effects of the medication wear off.
The amount of time patients must remain under supervision depends on a variety of factors, the type of procedure, the type of sedation provided and the body’s reaction to both.
Any after-effects of the medication must be minimal or gone before the patient will be discharged from the facility to go home. Patients will not be allowed to drive themselves home, so it is important to make arrangements for a responsible adult to provide transportation.