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
2Faculty of Medical Sciencies, University of Kragujevac, Kragujevac, Serbia
3University of Niš, Faculty of Sport and Physical Education, Niš, Serbia
4University Clinical Center Niš, Niš, Serbia
5Institute for Orthopedic Surgery „Banjica“, Belgrade, Serbia

 

  SUMMARY

  

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