Sedation and regional anaesthesia in the adult patient

Abstract

This review discusses sedation for regional anaesthesia in the adult population. The first section deals with general aspects of sedation and shows that the majority of patients receiving sedation for regional anaesthesia are satisfied and would choose it again. Methods of assessing the level of sedation are discussed with emphasis on clinical measures. The pharmacology of the drugs involved in sedation is discussed, with propofol and remifentanil appearing to be the combination of choice for sedation in regional anaesthesia. The techniques for administering sedation are discussed and replacement of the traditional repeated boluses or continuous infusion with pharmacokinetic and patient-controlled systems is supported. Patient satisfaction studies suggest that patient-controlled systems are preferred.

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

“…But many patients don't like to be awake to remember or recall the intraoperative procedure [46] and request for some form of sedation. The aim of sedation in regional anaesthesia technique include general patient comfort, freedom from specific discomfort and some amnesia for entire procedure [47].…”

Comparison of the sedative effects of midazolam and dexmedetomidine during regional anaesthesia

“…[9][10][11][12][13][14] Hastaların duyduğu korku ve anksiyeteyi azaltmak, rahatsızlığını hafifletmek, işlemle ilgili toleransını ve konforunu artırmak için benzodiazepinler, propofol, klonidin ve deksmedetomidin gibi alfa2 adrenoseptör agonistleri, sevofluran, ketamin ve opioidler anestezistler tarafından kullanılmaktadır. 4 Bizim çalışmamızda kullandığı-mız midazolam ve deksmedetomidin, metabolitlerinin inaktif olması ve resedasyona yol açmaması nedeniyle 15 uyguladığımız dozlarda hastalarımızın bilinçlerinin iletişim kurulabilecek kadar açık, ancak cerrahi konfor sağlayacak kadar sedatize olmalarını ve aynı zamanda derlenme kalitesinin yeterli olmasını sağlamıştır.…”

Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial

“…1 Anesthesiologists must balance patient satisfaction vs the risk of respiratory depression associated with oversedation. A review of closed claims has revealed that respiratory depression from oversedation has caused catastrophic adverse events such as brain damage and death.…”