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Sedation covers the states of
consciousness varying from
wakefulness to complete
blackout and has 3 varieties.
Patients can respond to vocal
commands in minimal sedation
and there is no effect on the
circulatory and respiratory
systems. Patients can give
minimal response to vocal
commands in moderate sedation
and require light touching.
The circulatory and respiratory
systems are mildly depressed,
however there is no need for an
intervention. Whereas in deep
sedation the patient does not
respond to vocal stimulant or
touching, but weak response can
be given to painful stimulants.
These patients require aid with
regard to airway potency and
oxygen should be applied.
Analgesia is the removal of
the pain of the patient via
an analgesic. Patient safety
is given particular priority in
sedoanalgesia applications.
The anxiety of the patient
decreases to a minimal level
or is zero. Other advantages
are the facts that the patient is
immobile during the operation,
quality sleep, quality waking,
no side effects and the short
discharge times following the
operation. Best sedative and
analgesic drugs are used for
this purpose. All systems of the
patient including the respiratory
and circulatory systems are
monitored throughout the
operation by an anesthetist and
he/she intervenes if there is any
abnormal event. Thus, patient
safety is provided by means of
a qualified anesthetist. The best
advantage of this procedure is
the fact that the patient remains
immobile throughout. It is very
important that the doctor carrying
out the endoscopy procedure
carries out the procedure
comfortably on an immobile
patient, that he/she sees and
diagnoses properly and that he/
she gets proper biopsy from the
patient.
“The American Society of
Anesthesiologists (ASA)” scale
is used when deciding on the
drug to be used during the
sedoanalgesia procedure, its
dose and means of application.
According to ASA, majority of the
painful procedures are carried
out via moderate sedation and
analgesia. However, depending
on the general status of the
patient, monitoring conditions
and the experience of the staff,
this can range from minimal
sedation to deep sedation.
The endoscopy unit setup, its
cleanliness and maintenance are
as important as the environment
where the procedure will
take place, the team and the
equipment to be used. The
endoscopy nurse accompanying
the doctor should be educated in
this procedure. The anesthetist
should carry out a systemic
examination and full scale
anamnesis to determine if there
is any chronic disease in order to
determine the drugs to be used.
Respiratory system and cardiac
evaluation is especially important
for patients over the age of 70.
ASA scale can be used when
evaluating the patient with regard
to already existing diseases and
the procedure.
