Introduction
Conscious sedation is the process that involves administration of medicines into the body which cause the patient to be relaxed and feel sleepy during a medical procedure or surgery, but keeps him conscious. The difference between being conscious and unconscious or subconscious is that in the former state, the patient does not get into a condition as that of one in general anesthesia. General anesthesia causes total unconsciousness.
Conscious sedation is a state in which local or topical anesthesia is given, which may cause the patient to sleep, but not be totally unconscious. This state helps the patient be free from anxiety during a medical procedure.
Drugs Used by Surgeon to Accomplish Conscious Sedation
Every surgeon has his or her own preference for prescribing drugs; similarly, individual preferences are made in the case of administering anesthesia to the patients too. An interview was conducted with Dr. George McQueen, who is currently in the dental department of the V.A. Hospital in Johnson City, TN. We had a telephone conversation regarding which drugs he would use on his patients, to put them in a state of conscious sedation while he carries out his medical procedures.
He declared he used Demerol 25-75mg titrate dosages, depending on the patient’s health, and the response attained via intravenous injections. He also used Midazolam, which is a form of benzodiazepine. It also has the trade name of Versed among others, and is used to induce sleep in patients during uncomfortable medical processes. It also causes sleep and is a sedative. He administers 1-5mg dosages to his patients, usually not exceeding 3mg, but again, depending on the condition of the patient, and his or her tolerance.
Nitrous oxide is also used by Dr. McQueen during his procedures, in a 30/50 combination. In case of occurrence of nausea during the procedure, he uses phenergan I.V. 12.5-25mg. if nausea occurs after completion of the procedure, he advises a phenergan suppository.
Role of the Medicines in Conscious Sedation
Demerol is used as a pain reliever. It is one of the narcotic pain relievers that are used to help reduce pain of moderate to high intensity (“Demerol”, 2009). Demerol is also used as a sedative, which is why it helps in conscious sedation. It is similar to morphine, which is used as an anesthetic. Demerol is preferred because it has shown little effects on respiration and circulation after entrance into the body, as compared to morphine.
Demerol has been used as an anesthetic because it causes vascular relaxation. If a patient is given too much Demerol, other medication can easily be given to reduce its side effects. It is used especially during nitrous oxide anesthesia.
Nitrous oxide is used as an anesthetic because of its advantages. It is non-toxic, and the body will not require detoxification once nitrous oxide has performed its functions (Brotman, M. & Cullen, S., 1948). It is easily diffusible into the body, and has good anesthetic control. Better results are produced if Demerol is given as a premedication.
Versed is an anti-anxiety medication. It is used to reduce the anxiety that may be caused in a patient, due to nervousness upon being operated. This is the reason for its administration while giving the patient conscious sedation. It has a similar reversal action like Demerol, in that if it causes side effects, they can be removed by other medicines.
References
Brotman, M. & Cullen, S. Supplementation with Demerol During Nitrous Oxide Anesthesia 1948. Web.
Demerol, 2009. Web.