ACTA FAC MED NAISS 2023;40(2):149-159 |
Review article
UDC:
616-089.5:615.21
DOI:
10.5937/afmnai40-38674
Running title:
Anesthesia outside the
Operating Room
Challenges in Procedural Sedation and Analgesia
Šćepan Sinanović1,2, Tanja Prodović1, Olivera Milovanović2, Saša Bubanj3, Miljan Krstović4, Srećko Potić1, Jelena Sekulić1, Danilo Jeremić5
1High
Medical College of Professional Studies “Milutin Milanković”,
Belgrade, Serbia
Introduction. There are several definitions given by various
anesthesiology professional organizations that explain the term
procedural sedation and analgesia (PSA). The International
Committee for the Advancement of PSA has defined procedural
sedation as the use of anxiolytics, sedatives, hypnotics,
analgesics and/or dissociative drugs to alleviate anxiety, pain
and/or movement. These agents are used to facilitate the
attainment of amnesia or to reduce the consciousness and/or
comfort and safety of the patient during diagnostic or
therapeutic procedures. The first guidelines for sedation are
based on the mandatory signing of informed consent, monitoring
and measuring of vital parameters, implementing a fasting
regimen before sedation, possessing the skills to establish and
maintain the airway, and resuscitation measures. Since PSA is
most often used outside the operating room, this type of
anesthesia activity is known as NORA (Non-Operating Room
Anesthesia Care).
Conclusion. Preprocedural evaluation and preparation,
periprocedural management, monitoring and care of postprocedural
recovery from PSA is similar to those of general or regional
anesthesia. In conclusion, a number of logistical and practical
difficulties should be noted, such as the availability of
medicines and appropriate staff training, as well as the
application of global guidelines on PSA.
Keywords: procedural sedation and
analgesia, monitored anesthesia care, moderate sedation
Corresponding author:
Šćepan Sinanović
e-mail: scepan.sinanovic@gmail.com