Procedural (Conscious) Sedation and Analgesia in Emergency Setting: How to Choose Agents?


Ayan M., Ozsoy O., Ozbay S., AKMAN C., Suzer N. E., Karcioglu O.

Current Pharmaceutical Design, vol.29, no.28, pp.2229-2238, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 29 Issue: 28
  • Publication Date: 2023
  • Doi Number: 10.2174/0113816128266852230927115656
  • Journal Name: Current Pharmaceutical Design
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, Chemical Abstracts Core, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.2229-2238
  • Keywords: analgesia, conscious sedation, drug, Pain management, procedural sedation, sedation
  • Çanakkale Onsekiz Mart University Affiliated: Yes

Abstract

Pain has long been defined as an unpleasant sensory and emotional experience originating from any region of the body in the presence or absence of tissue injury. Physicians involved in acute medicine commonly undertake a variety of invasive and painful procedures that prompt procedural sedation and analgesia (P-SA), which is a condition sparing the protective airway reflexes while depressing the patient’s awareness of ex-ternal stimuli. This state is achieved following obtaining the patient’s informed consent, necessary point-of-care monitoring, and complete recording of the procedures. The most commonly employed combination for PSA mostly comprises short-acting benzodiazepine (midazolam) and a potent opioid, such as fentanyl. The biggest advantage of opioids is that despite all the powerful effects, upper airway reflexes are preserved and of-ten do not require intervention. Choices of analgesic and sedative agents should be strictly individualized and determined for the specific condition. The objective of this review article was to underline the characteristics, effectiveness, adverse effects, and pitfalls of the relevant drugs employed in adults to facilitate PSA in emergency procedures.