So you want to know what is conscious sedation? Conscious sedation is a middleman. There are a handful of procedures that are more than simple but less than complex. That’s where sedation comes in.
Conscious sedation helps to bridge the gap for patient comfort.
Let’s first think of conscious sedation by using the most common examples: in dentistry and gastroenterology. Both fields are part of routine recommended healthcare and both involve access to various parts of the digestive tract. Although neither is considered majorly invasive, dental treatment, as well as colonoscopies or endoscopies, are not exactly a walk in the park for a patient.
Enter conscious sedation.
Patients often elect for sedation when the procedure is invasive enough to create anxiety, but not evasive enough to warrant general anesthesia in an operating room. In this article we will discuss what is conscious sedation, what is conscious sedation like, and common conscious sedation drugs.
What is Conscious Sedation
Let’s get straight to it. The goal of conscious sedation is comfort. It enables comfort during a procedure that otherwise may be less than comfortable without it.
Okay, so sedation makes a medical or dental procedure comfortable. Next logical question is, how does it do that? By controlling anxiety and pain.
Conscious sedation generally utilizes a blend of medications that serve to reduce anxiety, discomfort, and pain during certain procedures. It is important to note that the comfort I speak of is systemic.
In other words, sedation affects the way a person “perceives” pain. Perception affects the senses of the entire body.
In addition to conscious sedation, local anesthesia is also used during the procedure. It does exactly as it sounds.
Local anesthesia blocks the “feeling” of pain in the area being worked on.
The benefit of utilizing both local anesthesia and sedation is they manage both the perception of pain and the feeling of pain. Allow me to explain with an example. Have you ever been exhausted after a long day, one of those days when nothing seemed to go well? Suddenly things that wouldn’t annoy you, begin to annoy you. Everything seems overwhelming, frustrating, and down-right aggravating. That’s an example of how our environment can greatly change our perception.
Studies show that stress affects our sensitivity to frustration. The same goes for dental work or the not so pleasant colonoscopy. The environment can put patients on edge. When that happens, the lines between pain and discomfort begin to blur. The threshold for our tolerance lowers. Conscious sedation helps to reduce our body’s reaction and perception of discomfort.
After all, whether we are uncomfortable or not, has a lot to do with whether we acknowledge that discomfort.
But Is Sedation Safe?
Studies show that conscious sedation is very safe when performed by a board-certified professional. The professional may be a physician, dentist, oral surgeon, anesthesiologist, etc. However, one commonality must exist. The provider must have completed rigorous training in cardiovascular and respiratory physiology as well as training within a clinic or hospital setting.
The provider and their team should monitor the breathing and heart rate of the patient at all times during the sedation procedure.
There are also three different types of conscious sedation. Each type requires different degrees of monitoring of the patient during the procedure. The following types of conscious sedation are listed below:
- Minimal (anxiolysis). You’re relaxed but fully conscious and responsive
- Moderate. You’re in a dreamlike state and may lose consciousness, but you’re still able to respond
- Deep. You’ll fall fully asleep, be unresponsive to purposeful commands, but you’re still able to breathe on your own.
What is Conscious Sedation Like?
So that got a bit technical. Let’s get back to reality and what you really want to know. What does conscious sedation feel like?
It varies based on the different levels. However, the level of sedation is selected based on the level of anxiety for the medical or dental procedure.
The most common feelings are drowsiness and relaxation. Think of those times when you are on vacation and somehow always fall asleep without a care in the world. That’s the type of relaxing feeling you feel before falling asleep. Once the sedative takes effect, negative emotions, stress, or anxiety gradually begin to fade.
During conscious sedation you may be aware during the time you are falling asleep, however, afterward, you may not remember ever being awake.
Some people feel a tingling sensation and some feel a sensation of heaviness or sluggishness. Often patients describe the sensation similar to a weighted blanket. There’s a sense of protection and comfort to the sensation of heaviness. It may feel like it’s not worth the effort to care to move.
Sensations or sounds that would bother you when you were not sedated, typically will not be perceived as such any longer. Its like one of those dreams where you feel as if you can fly around the city with your arms stretched out as a bird. The sedation medications blur the reality of what you perceive you are capable of achieving or tolerating.
What is Recovery Like?
Conscious sedation recovery is often uneventful. You will wake up after the procedure at the office, although you may not remember. The first hour or two after sedation may be foggy to remember even though you are awake. You may wake up in the same room the procedure began or you may have been moved to a recovery room. Typically when you wake up your dentist or physician will still be monitoring your heart and ventilation. You may have a blood pressure cuff and other monitoring items on you.
You will generally wake up without pain as the local anesthetic is designed to last the first few hours during recovery.
Some side effects may last for the rest of the day. Common side effects that are normal after conscious sedation include drowsiness, headaches, nausea, and sluggishness. Often your provider will give you medications during the procedure to help limit these side effects.
Plan to bring a family member or friend who can drive or take you home for all forms of sedation more than nitrous oxide. You may be tempted to plan to take an Uber or taxi, however, think again. It is not safe to have a stranger take you home alone.
Plan to take the whole day off from work. Avoid heavy exercise, heavy machinery, or big life decisions until the medication side effects fully wear off within 12-24 hours
What are Common Conscious Sedation Drugs
The drugs used in conscious sedation vary to some degree based on how anxious you are, the length of the procedure, and your medical history including allergies.
Your provider will discuss the goals of the level of sedation with you and will then determine the appropriate combination and dosages of medications. Some common conscious sedation drugs are:
Inhalational Medication. Conscious sedation medications delivered by breathing a gas continuously during the procedure. An example is Nitrous oxide.
Oral Medications: Conscious sedation medications delivered by taking a pill prior to or during the procedure. Examples are (Valium) or triazolam (Halcion).
Intravenous Medications. Conscious sedation medications delivered periodically during the procedure by an IV in your arm. Examples are Midazolam (Versed), fentanyl, and/or Propofol (Diprivan).
Wrap Up: What is Conscious Sedation & What is Conscious Sedation Like
Conscious sedation is all about comfort.