Conscious Sedation & General Anesthesia

What is the goal of concious sedation?

Control fear & anxiety

What are the 3 methods of conscious sedation?

• Oral

• Inhalation

• IV

Conscious sedation

• Minimal depression

• Maintains airway

• Responds to commands

What stage is conscious sedation?

Stage I (analgesia)

What happens in Stage II anesthesia?

• Excitement

• Loss of awareness

• Uncooperative

What happens in Stage III?

• Unconscious

• No reflexes

• No response

What happens in Stage IV?

Respiratory/cardiac failure

What drug class is used for conscious sedation?

Benzodiazepines

What reverses benzodiazepines?

Flumazenil

What are nitrous oxide effects?

Analgesia & sedation

How is nitrous oxide absorbed & excreted?

Inhaled & exhaled through lungs unchanged

Who can drive after nitrous sedation?

Patient can drive themselves

Who needs an escort?

Oral and IV sedation patients

What color are nitrous and oxygen tanks?

• Nitrous = blue

• Oxygen = green

What shows respirations on nitrous unit?

Reservoir bag (2/3 full)

What removes excess nitrous gas?

Scavenger system

What is the most important monitor?

The patient

What are signs of over-sedation?

• Nausea

• Incoherent

• Uncoordinated

• Mouth closing

How do you correct over-sedation?

• Increase O2

• Decrease nitrous oxide

What is given after nitrous is stopped?

100% oxygen for 3-5 minutes

What determines proper flow rate?

Tidal volume

When are vitals taken?

• Before

• During

• After

When is nitrous indicated?

Mild anxiety

Key contraindications for nitrous?

• Pregnancy (1st trimester)

• Respiratory issues

Why is oral sedation limited?

Slow onset + cannot adjust easily