What are the levels of sedation?

Updated: Nov 06, 2018
  • Author: Arul M Lingappan, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

Sedation is the depression of a patient's awareness to the environment and reduction of his or her responsiveness to external stimulation. This is accomplished along a continuum of sedation levels:

  • Minimal sedation is equivalent to anxiolysis, that is, a drug-induced relief of apprehension with minimal effect on sensorium.

  • Moderate sedation is a depression of consciousness in which the patient can respond to external stimuli (verbal or tactile). Airway reflexes, spontaneous ventilation, and cardiovascular function are maintained.

  • Deep sedation is a depression of consciousness in which the patient cannot be aroused but responds purposefully to repeated or painful stimuli. The patient may not be able to maintain airway reflexes or spontaneous ventilation, but cardiovascular function is preserved.

  • General anesthesia is a state of unconsciousness; the autonomic nervous system is unable to respond to surgical or procedural stimuli.

  • Dissociation, which could be considered a type of moderate sedation, is seen when using medications in the phencyclidine group (eg, ketamine). They cause a disconnection between the thalamoneocortical system and the limbic systems, preventing higher centers from receiving sensory stimuli. Like moderate sedation, airway reflexes, spontaneous ventilation, and cardiovascular function are all maintained. [1, 2]


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