TY - JOUR
T1 - Indications, contraindications, and safety aspects of procedural sedation
AU - van Haperen, Maartje
AU - Preckel, Benedikt
AU - Eberl, Susanne
PY - 2019
Y1 - 2019
N2 - PURPOSE OF REVIEW: There is a steadily increasing demand for procedural sedation outside the operating room, frequently performed in comorbid high-risk adult patients. This review evaluates the feasibility and advantages of sedation vs. general anesthesia for some of these new procedures. RECENT FINDINGS: Generally, sedation performed by experienced staff is safe. Although for some endoscopic or transcatheter interventions sedation is feasible, results of the intervention might be improved when performed under general anesthesia. For elected procedures like intra-arterial treatment after acute ischemic stroke, avoiding general anesthesia and sedation at all might be the optimal treatment. SUMMARY: Anesthesiologists are facing continuously new indications for procedural sedation in sometimes sophisticated diagnostic or therapeutic procedures. Timely availability of anesthesia staff will mainly influence who is performing sedation, anesthesia or nonanesthesia personal. While the number of absolute contraindications for sedation decreased to almost zero, relative contraindications are becoming more relevant and should be tailored to the individual procedure and patient.
AB - PURPOSE OF REVIEW: There is a steadily increasing demand for procedural sedation outside the operating room, frequently performed in comorbid high-risk adult patients. This review evaluates the feasibility and advantages of sedation vs. general anesthesia for some of these new procedures. RECENT FINDINGS: Generally, sedation performed by experienced staff is safe. Although for some endoscopic or transcatheter interventions sedation is feasible, results of the intervention might be improved when performed under general anesthesia. For elected procedures like intra-arterial treatment after acute ischemic stroke, avoiding general anesthesia and sedation at all might be the optimal treatment. SUMMARY: Anesthesiologists are facing continuously new indications for procedural sedation in sometimes sophisticated diagnostic or therapeutic procedures. Timely availability of anesthesia staff will mainly influence who is performing sedation, anesthesia or nonanesthesia personal. While the number of absolute contraindications for sedation decreased to almost zero, relative contraindications are becoming more relevant and should be tailored to the individual procedure and patient.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85074551614&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31389805
U2 - https://doi.org/10.1097/ACO.0000000000000777
DO - https://doi.org/10.1097/ACO.0000000000000777
M3 - Article
C2 - 31389805
SN - 0952-7907
VL - 32
SP - 769
EP - 775
JO - Current opinion in anaesthesiology
JF - Current opinion in anaesthesiology
IS - 6
ER -