your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Continuum of sedation/analgesia/anesthesia

	Minimal sedation (anxiolysis)*	Moderate sedation/analgesia (conscious sedation)^¶	Deep sedation/analgesia^Δ	General anesthesia^◊
Responsiveness	Normal response to verbal stimulation	Purposeful^§ response to verbal or tactile stimulation	Purposeful^§ response after repeated or painful stimulation	Unarousable, even with painful stimulus
Airway	Unaffected	No intervention required	Intervention may be required	Intervention often required
Spontaneous ventilation	Unaffected	Adequate	May be inadequate	Frequently inadequate
Cardiovascular function	Unaffected	Usually maintained	Usually maintained	May be impaired

Because sedation is a continuum, it is not always possible to predict how an individual patient will respond. Hence, practitioners intending to produce a given level of sedation should be able to rescue patients whose level of sedation becomes deeper than initially intended. Individuals administering moderate sedation/analgesia (conscious sedation) should be able to rescue patients who enter a state of deep sedation/analgesia, while those administering deep sedation/analgesia should be able to rescue patients who enter a state of general anesthesia.

* A drug-induced state during which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.
¶ A drug-induced depression of consciousness during which patients respond purposefully^§ to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patient airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
Δ A drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully^§ following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patient airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
◊ A drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patient airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
§ Reflex withdrawal from a painful stimulus is not considered a purposeful response.

From: American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002; 96:1004. Copyright © 2002 American Society of Anesthesiologists. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.

Graphic 113984 Version 2.0