Patient Sedation and Pain Management

1

What is the purpose of sedation and pain management during an interventional radiology procedure?

The purpose is to enable a patient to tolerate a potentially painful procedure yet still maintain satisfactory cardiopulmonary function and the ability to cooperate with verbal commands and tactile stimuli.

2

What is the difference between analgesia and anesthesia?

Analgesia is the relief of pain without alteration of a patient's state of awareness. Anesthesia is the state of unconsciousness.

3

What is the difference between anxiolysis and amnesia?

Anxiolysis is the relief of fear or anxiety without alteration of awareness. Amnesia is the loss of memory.

4

What capabilities should the patient maintain during conscious sedation?

The patient should:

• Remain responsive and cooperative.

• Maintain spontaneous ventilation.

• Be able to protect the airway.

• Maintain protective reflexes.

5

Describe the levels of patient sedation.

The levels of patient sedation exist along a continuum: light sedation, moderate sedation, deep sedation, and general anesthesia. A patient under light sedation can respond to stimuli and maintains intact airway reflexes. A patient under moderate sedation should maintain spontaneous ventilation and be able to protect the airway. A patient under deep sedation can respond to vigorous stimuli but may lack airway reflexes. A patient under general anesthesia has no response to stimuli and lacks all protective reflexes.

6

List the details that should be included in the presedation evaluation of a patient.

• Patient medical history.

• Previous adverse experience to sedation or anesthesia.

• Current medication use and drug allergies.

• Time and nature of last oral intake.

• History of alcohol or substance abuse.

• Focused physical examination including heart, lungs, and airway.

• Pertinent clinical laboratory findings.

7

How long should a patient typically fast before undergoing conscious sedation?

A patient should not have solid foods for 6 to 8 hours and clear liquids for 2 to 3 hours before undergoing sedation.

8

The physical status of a patient is often measured on a 6-point scale, known as the American Society of Anesthesiologists (ASA) Physical Status (PS) classification. Describe this scale.

• ASA I: Normal healthy patient.

• ASA II: Patient with mild systemic disease, without substantive functional limitations.

• ASA III: Patient with severe systemic disease, with substantive functional limitations.

• ASA IV: Patient with severe systemic disease that is life-threatening.

• ASA V: Moribund patient with a poor chance for survival without surgery.

• ASA VI: Declared brain-dead patient whose organs are being removed for donor purposes.

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