What is Procedural Sedation

Procedural Sedation and Analgesia (PSA) is the safe and effective administration of drugs that relieve anxiety and reduce pain. The aim of conscious sedation is to make the patient as comfortable as possible, whilst monitoring the patient continuously, so that the procedure can be completed in a completely safe environment.

Certain procedures (medical and dental) can be performed safely and efficiently under sedation outside of the theatre environment (i.e. in the dentist or medical practitioners rooms). Sedation presents a cost-effective alternative to general anaesthetic (in certain procedures) and can be done in appropriately equipped dentists’ or doctors’ facilities. Sedation is an ideal alternative for the patient who dreads a traumatic theatre experience.

Not only is anxiety minimised, patients are back on their feet sooner, without the long recovery period of a general anaesthetic. The side effects experienced with sedation are much less than with a general anaesthetic – very few patients experience any side effect at all. The incidence of post sedation nausea and vomiting is as low as 0.7%.

Costs of sedation are significantly lower if compared to the traditional theatre based general anaesthetic option. Patients and medical aids when choosing conscious sedation as an option realise considerable savings.

The versatility and safety of sedation coupled with the many benefits to the patient make sedation the perfect choice for many medical and dental procedures.

FAQs

How does Procedural sedation differ from general anaesthesia?

Procedural sedation is a partial suppression of consciousness. The patient will feel relaxed and comfortable and some patients even sleep during the procedure. During conscious sedation patients can be aroused verbally and will respond appropriately to questions and stimuli. General anaesthetic is used in procedures where the anaesthesiologist totally suppresses the patients’ consciousness and sometimes also manages the patients breathing, etc. Larger dosages of drugs are needed to give a patient a general anaesthetic. A general anaesthetic can only be done in a hospital with the appropriate facilities.

If I am conscious during the procedure, will I feel pain?

No. In most procedures done under sedation the administration of local anaesthetic will effectively block pain. The goal of conscious sedation is to control anxiety and pain. The sedation practitioner will thus give you certain drugs to reduce pain during the procedure as well as drugs that will help with post-operative pain control. This in combination with the administration of the local anaesthetic will give you optimal pain relief during the procedure.

How long does it take to ‘wake up’ after the procedure?

The recovery time depends on the drugs used, the patients individual response to the drugs and the time spent under sedation. During a sedation your consciousness will never be totally suppressed as with a general anaesthetic – thus the term “conscious sedation”. Some patients are sleepier than others and some will even sleep through the procedure. The patient can however be aroused by verbal command or physical stimuli. After the infusion of the drugs has stopped, recovery is swift. In most cases this recovery time is 15 – 30 minutes.

What side effects can occur after a sedation?

The side effects after sedation is much less than with a general anaesthetic. Almost none of the patients experience nausea after the sedation. One of the drugs used during the sedation has a strong anti-nausea effect. The incidence is only 0.7%.

What can I do for the rest of the day?

You should be able to leave the aftercare after 15 – 45 minutes. You are however not allowed to drive yourself home. You will not be able to leave the doctors’ or dentists’ rooms if there is not a responsible adult that can drive you home. For the rest of the day you are not allowed to sign any legally binding documents and you are not allowed to take part in any activities that require alertness or coordination (this is for at least 12 hours following treatment). You will not be able to return to work on the same day as the sedation. You should remain in the company of a responsible adult for 12 hours following the sedation.

Will my medical aid fund pay for my sedation?

Most medical aid funds are aware of the financial advantages of conscious sedation and are therefore willing to cover the procedure. However, it is advisable to check with your medical aid beforehand, to find out if they will cover the sedation. Some medical aid funds will only cover a part of the fees. It is your own responsibility to obtain authorisation from your medical aid fund. Cape Sedation Services does not claim from medical aids and therefore the account for the sedation has to be settled on the day of the procedure. Patients who want to claim from their medical aids will receive a detailed account after the sedation, which they can submit to their medical aid fund.

Who is qualified to perform procedural sedation?

General Practitioners or Anaesthetists who have had specific postgraduate training in procedural sedation.

The Process