Chapt 15: Sedation Key Terms – The Anesthesia Technologist’s Manual, Chapter 15

Vocabulary-style flashcards covering key terms, definitions, and concepts related to sedation levels, monitoring, medications, preparation, and safety from the notes.

Sedation

A service to calm and relax patients for procedures not requiring full general anesthesia, with depth titrated to minimize risks.

Minimal Sedation (Anxiolysis)

Drug-induced anxiolysis where the patient responds normally to verbal commands; airway, ventilation, and cardiovascular function remain intact.

Moderate Sedation/Analgesia

Drug-induced depression of consciousness with purposeful response to verbal commands; no airway interventions needed; spontaneous ventilation and cardiovascular function are usually adequate.

Deep Sedation/Analgesia

Drug-induced depression where the patient cannot be easily aroused but can respond after repeated or painful stimulation; ventilation may be impaired; airway assistance may be required; cardiovascular function usually maintained.

General Anesthesia

Drug-induced loss of consciousness where the patient cannot be aroused, even by painful stimulation; ventilation is often impaired and airway management may be required.

Monitored Anesthesia Care (MAC)

Any level of sedation delivered by anesthesia professionals—not limited to deep sedation.

Conscious/Nursing Sedation

Older term for moderate sedation administered by non-anesthesia providers (often nurses) credentialed by the institution.

ASA Guidelines

Standards and guidelines from the American Society of Anesthesiologists guiding sedation depth and risk mitigation.

CMS

Centers for Medicare and Medicaid Services; regulatory oversight of sedation practices with ASA standards.

Pre-sedation evaluation

Initial assessment before sedation, including physical exam and airway assessment, plus review of medical history.

Airway assessment

Evaluation of airway anatomy and risk factors to anticipate potential airway compromise during sedation.

Fasting (NPO)

Mandatory pre-sedation fasting to reduce aspiration risk.

Standard monitoring

Required monitoring during sedation: heart rate, blood pressure, EKG, pulse oximetry, and EtCO2.

End-tidal CO2 (EtCO2)

Measurement of CO2 at the end of exhalation to monitor ventilation; portable EtCO2 used for out-of-operating-room sedation.

OOR sedation

Out-of-operating-room sedation performed outside the traditional OR setting.

Airway management tools

Equipment for airway management (e.g., suction, bag-valve-mask) and resuscitation supplies.

Reversal drugs

Medications used to reverse sedative effects (e.g., naloxone for opioids, flumazenil for benzodiazepines).

Naloxone

Opioid reversal agent used to counteract opioid-induced respiratory depression.

Flumazenil

Benzodiazepine reversal agent used to counteract benzodiazepine effects.

Propofol

Rapid-onset/offset sedative often given as titrated infusion; reduces nausea but carries risks of hypotension and apnea; administration restricted to anesthesia professionals for sedation per ASA.

Dexmedetomidine

Anxiolytic/sedative/analgesic that preserves spontaneous respiration; useful for awake fiberoptic procedures and prolonged ICU sedation.

Ketamine

Dissociative anesthetic that preserves airway reflexes, breathing, and cardiovascular stability; useful when opioids are risky; can cause hallucinations and emergence delirium.

Benzodiazepines (Midazolam/Versed)

Anxiolytics with amnestic effects; risk of paradoxical agitation in elderly.

Opioids (Fentanyl/Alfentanil)

Analgesics used with sedatives; opioids plus benzodiazepines have synergistic respiratory depressant effects; reversal agents include naloxone.

Regional/Neuraxial nerve blocks

Regional anesthesia with sedation titrated to allow verbal reporting during block placement; failure may require general anesthesia.

Awake fiberoptic bronchoscopy

Procedure where dexmedetomidine is favored due to airway preservation and patient comfort.

MRI sedation considerations

Sedation in MRI is challenging due to limited provider access and equipment; often involves benzodiazepines and continuous infusions.

Interventional Radiology sedation

Sedation for percutaneous, minimally painful procedures requiring the patient to remain still for long periods.