Management of complications of moderate and deep sedation

Introduction Intravenous pharmacological sedation is widely used for various surgical and nonsurgical procedures by anesthesia providers or other trained professionals. In general, the use of intravenous sedation offers patients undergoing diagnostic and therapeutic procedures a positive experience, reducing or eliminating the fear, anxiety, pain, and discomfort associated with these procedures. There are also added benefits of reducing stress on the cardiovascular system. Sedation is described as a continuum, and it is often categorized according to the patient's level of consciousness as minimal, moderate, and deep sedation (Figure 11.1). This categorization is very subjective, with no objective cutoff line between the categories, and it does not take the sedative/hypnotic dosing strategies into account. There are overlapping zones between categories. In clinical practice, there is a gray area between deep sedation and general anesthesia; many so called “deep sedations” are virtually general anesthesia.