ABSTRACT
Complex medical procedures requiring the administration of sedation and analgesia
are frequently performed in sites outside the operating room. In particular, interventional
radiologists must understand basic principles of sedation and analgesia to direct
nurses or nurse practitioners to provide adequate conscious sedation. The purpose
of this article is to review basic principles of sedation, pharmacologic agents used
for sedation and analgesia, practice guidelines, monitoring, and management of common
hemodynamic problems encountered during sedation.
KEYWORDS
Sedation - analgesia - practice guidelines - nonanesthesiologist
REFERENCES
- 1
American Society of Anesthesiologists Task Force on Sedation by Nonanesthesiologists
.
Practice guidelines for sedation and analgesia by non-anesthesiologists.
Anesthesiology.
2002;
96
1004-1017
- 2
Practice guidelines for preoperative fasting and the use of pharmacologic agents for
the prevention of pulmonary aspiration: application to healthy patients undergoing
elective procedures: a report by the American Society of Anesthesiologist Task Force
on Preoperative Fasting .
Anesthesiology.
1999;
90
896-905
- 3
Roberts R B, Shirley M A.
Reducing the risk of gastric aspiration during cesarean section.
Anesth Analg.
1974;
53
859-868
- 4
Rocke D A, Brock-Utne J G, Rout C C.
At risk for aspiration: new critical values of volume and pH?.
Anesth Analg.
1993;
76
666
- 5
Vargo J J, Zuccaro G, Dumot J et al..
Gastroenterologist-administered propofol versus meperidine and midazolam for advanced
upper endoscopy: a prospective randomized trial.
Gastroenterology.
2002;
123
8-16
- 6
Rex D K, Sipe B W, Kinser K M et al..
Safety of propofol administered by registered nurses with gastroenterologist supervision
in 2,000 endoscopic cases.
Am J Gastroenterol.
2002;
97
1159-1163
- 7
Wittels E H, Thompson S.
Obstructive sleep apnea and obesity.
Otolaryngol Clin North Am.
1990;
23
751-760
- 8 Barash PG, Cullen BF, Stoelting RK
Clinical Anesthesia. 2nd ed. Philadelphia; JB Lippincott 1992: 1559
- 9 Morgan GE, Mikhail MS
Clinical Anesthesiology. 2nd ed. Stamford, CT; Appleton & Lange 1996: 304
Catherine TuiteM.D.
Assistant Professor of Radiology and Surgery, Division of Interventional Radiology,
Hospital of the University of Pennsylvania
3400 Spruce Street, Philadelphia, PA 19104