Conscious sedation for surgical procedures
Definition
Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedure. You will probably stay awake, but may not be able to speak.
Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.
Alternative Names
Anesthesia - conscious sedation
Description
A nurse, health care provider, or dentist, will give you conscious sedation in the hospital or outpatient clinic. Most of the time, it will not be an anesthesiologist. The medicine will wear off quickly, so it is used for short, uncomplicated procedures.
You may receive the medicine through an intravenous line (IV, in a vein) or a shot into a muscle. You will begin to feel drowsy and relaxed very quickly. If your provider gives you the medicine to swallow, you will feel the effects after about 30 to 60 minutes.
Your breathing will slow and your blood pressure may drop a little. Your provider will monitor you during the procedure to make sure you are OK. This provider will stay with you at all times during the procedure.
You should not need help with your breathing. But you may receive extra oxygen through a mask or IV fluids through a catheter (tube) into a vein.
You may fall asleep, but you will wake up easily to respond to people in the room. You may be able to respond to verbal cues. After conscious sedation, you may feel drowsy and not remember much about your procedure.
Why the Procedure Is Performed
Conscious sedation is safe and effective for people who need minor surgery or a procedure to diagnose a condition.
Some of the tests and procedures that conscious sedation may be used for are:
- Breast biopsy
- Dental prosthetic or reconstructive surgery
- Minor bone fracture repair
- Minor foot surgery
- Minor skin surgery
- Plastic or reconstructive surgery
- Procedures to diagnose and treat some stomach (upper endoscopy), colon (colonoscopy), lung (bronchoscopy), and bladder (cystoscopy) conditions
Risks
Conscious sedation is usually safe. However, if you are given too much of the medicine, problems with your breathing may occur. A provider will be watching you during the whole procedure.
Providers always have special equipment to help you with your breathing, if needed. Only certain qualified providers can administer conscious sedation.
Before the Procedure
Tell the provider:
- If you are or could be pregnant
- What medicines you are taking, even medicines, supplements, or herbs you bought without a prescription
During the days before your procedure:
- Tell your provider about allergies or health conditions you have, what medicines you are taking, and what anesthesia or sedation you have had before.
- You may have blood or urine tests and a physical exam.
- Arrange for a responsible adult to drive you to and from the hospital or clinic for the procedure.
- If you smoke, try to stop. Smoking increases the risk for problems such as slow healing. Ask your provider for help quitting.
On the day of your procedure:
- Follow instructions about when to stop eating and drinking.
- Do not drink alcohol the night before and the day of your procedure.
- Take the medicines your provider told you to take with a small sip of water.
- Arrive at the hospital or clinic on time.
After the Procedure
After conscious sedation, you will feel sleepy and may have a headache or feel sick to your stomach. During recovery, your finger will be clipped to a special device (pulse oximeter) to check the oxygen levels in your blood. Your blood pressure will be checked with an arm cuff about every 15 minutes.
You should be able to go home 1 to 2 hours after your procedure.
When you are home:
- Follow your provider's instructions about when and what to eat and drink.
- You should be able to return to your everyday activities the next day.
- Avoid driving, operating machinery, drinking alcohol, and making legal decisions for at least 24 hours.
- Check with your provider before taking any medicines or herbal supplements.
- If you had surgery, follow your provider's instructions for recovery and wound care.
Outlook (Prognosis)
Conscious sedation is generally safe, and is an option for procedures or diagnostic tests.
References
Hernandez A, Sherwood ER. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 14.
Vuyk J, Sitsen E, Reekers M. Intravenous anesthetics. In: Grooper MA, ed. Miller's Anesthesia. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 23.
Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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