Deep Sedation

What is deep sedation?

When you are given medicine to help your relax and make you very sleepy, it is called deep sedation. The medicines also help decrease your worries and make you feel more comfortable. Deep sedation may be used during a procedure, or to help your body heal after an accident or injury. While you are deeply sedated, your heart's function will not change, but you may need help breathing. Monitored anesthesia care (MAC) may be used. With MAC, a caregiver called an anesthesiologist will see that you are breathing normally during a procedure. He will also watch for changes with how your heart is beating. Having deep sedation will help keep you calm and relaxed before, during, and after a painful treatment, procedure, or surgery.

Why may I need deep sedation?

Deep sedation can help you forget painful or unpleasant things that occur during a period of time. It can help you hold still during a procedure. Deep sedation can help you feel comfortable while you stay in an intensive care unit (ICU). Since deep sedation will make your body rest, it may help you get better faster. This type of sedation is also used for procedures where your muscles need to be relaxed. Deep sedation may also be used for people who need a ventilator (breathing machine). MAC may be used along with anesthesia during a procedure. Local or regional anesthesia is used to make you lose feeling in a body area where the procedure is being done.

When may deep sedation be used?

  • Deep sedation may be used when a sample of tissue needs to be taken from a body area (biopsy). It may be used when deep brain stimulation is needed to treat Parkinson disease. Deep sedation can be used to remove cataracts. Cataracts cause problems such as hazy and blurred vision. Deep sedation may be given if you need to have a broken bone repaired. It can be used when caregivers need to drain pus out of an infected body area (incision and drainage).

  • Joints are places in your body where two bones meet, such as your knees and elbows. Car accidents or injuries caused by falls can make your joint move out of the right place. To put the joint back into the right place, you may need deep sedation. You may get deep sedation if you need surgery to open your skull (craniotomy), or to treat seizures. You may be given deep sedation to decrease pain if caregivers are cleaning or fixing an open wound. Open wounds can be burns, cuts, or skin scrapes.

Is deep sedation used during certain tests and procedures?

  • Deep sedation may be used if you need to have a cardiac catheterization. This is a procedure done to check for blocked blood vessels and other problems with your heart. It may be given to you if you need cardioversion. This is when caregivers give an electric shock to your heart to help it beat regularly. Deep sedation may be used if you need to have a large intravenous tube (IV) placed into a blood vessel. It may be given if you need to have a tube placed in your trachea (windpipe) or your chest. It can also be used to remove an object that is stuck in the ear, or another body opening. Deep sedation may also be used if you need to have a tooth pulled, a root canal, or other dental work.

  • You may get deep sedation during tests where a scope is used. A scope is a long tube with a light and magnifying glass or camera on the end. Caregivers put one end of the scope into a body opening. They move the scope forward as they look at body organs and tissues. Samples of tissue may be collected, small growths removed, and areas of bleeding found and treated. These procedures may include a bronchoscopy, colonoscopy, endoscopy, sigmoidoscopy, or a thoracoscopy. Deep sedation may be used to collect a sample of fluid from around your spinal cord (lumbar puncture). If you need to have one of these procedures, ask your caregiver for more information about it.

Who may not have deep sedation?

You may not be able to have deep sedation if:

  • You are allergic to foods such as eggs or soybeans.

  • You are allergic to the medicines that will be given.

  • You are pregnant or obese (weighing more than what your caregiver says is OK).

  • You have heart or lung disease.

  • You have medical problems such as head and neck cancer.

What medicines are used for deep sedation?

Medicines used for deep sedation may be given as a pill, shot, or through your anus. You may also breathe them into your lungs, or get them through an IV tube. You may have one or more of the following medicines:

  • Anesthesia: This is medicine that will help you feel more comfortable during a procedure or surgery.

  • Antianxiety medicine: This medicine may be given to decrease anxiety and help you feel calm and relaxed.

  • Narcotics: This group of medicines may be given for pain during or after a procedure or surgery.

  • Sedative: This medicine is given to help you stay calm and relaxed.

What are the risks of having deep sedation?

  • The medicine used for deep sedation may cause headaches. You may have an upset stomach or throw up. You may have pain in the area where shots of medicine are given. You may be allergic to the medicine, and get itchy skin, watery eyes, and have more than normal saliva (spit). The medicine might make you forget things that have happened recently. Having too little medicine may make you nervous, and cause you to feel pain during the procedure or surgery. You may also begin moving when you need to hold still.

  • If you get more medicine than you need, you may be unconscious. Your caregiver may have trouble waking you up. Your breathing may not be regular, or it may stop. When this happens, you may need a ventilator (machine) to help you breathe. You may also have short time periods when your blood pressure goes too low. If the medicine does not wear off, you may need other medicines to make you become alert or awake.

  • Having heart or lung disease or a head injury puts you at higher risk of having problems. These problems can happen during or after you get deep sedation. Older adults and people who use illegal (street) drugs have a greater risk of having problems. Those who drink too much alcohol too often may also be at risk of having problems. Alcohol is found in adult drinks such as beer, wine, and whiskey. Ask your caregiver if you have questions or concerns about having deep sedation.

What should I expect before deep sedation is used on me?

  • Medical history: Your caregiver will ask you if you have had medical problems or surgeries in the past. Tell caregivers if you are allergic to eggs or soy, or if you have other allergies. Tell them about all the medicines that you use. Tell caregivers if you use street drugs or drink alcohol, such as beer and wine. If you are female, tell your caregiver if you know or think you might be pregnant.

  • Physical exam: Your caregiver will check your weight and vital signs. Vital signs include your temperature, blood pressure, and breathing. Caregivers will check for loose teeth, and any other medical conditions or problems with movement.

  • Drinking liquids: If your procedure is planned, ask your caregiver if you should not eat food or drink liquids for a certain time before the procedure. Your caregiver may ask you not to drink at least two hours before sedation. A small meal may be eaten six hours before having deep sedation.

  • Consent: You will be asked to sign a consent form that allows your caregiver to use sedation. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that states what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

What may happen while I am having deep sedation?

During deep sedation, your blood pressure, breathing, heart rate, and temperature will be checked often. Your caregiver may ask you questions. While in deep sedation you will react if caregivers shake or poke you. You may move away from something that is poking you. The medicine that you get during a procedure may wear off, and you may feel pain or discomfort. Your caregiver may need to give you more medicine.

What should I expect after I have deep sedation?

You will be taken to a room where you can rest and caregivers will check on you. Do not get out of bed until your caregiver says it is OK. To learn if the medicine is wearing off, caregivers will say your name and see if you answer to it. They may ask you to move your arms and legs, cough, and take deep breaths. If you feel very tired and do not respond to poking or shaking, you are not ready to go home. If you are very confused and cannot follow directions, you will not be able to go home. You may be able to leave when you are fully awake and talking and acting as you did before having deep sedation. You may not be able to remember what happened when deep sedation was used on you. Ask caregivers what happened when you were sedated. You may need any of the following after having deep sedation:

  • IV fluids: Fluids that contain water, minerals, sugar, and other things that your body needs may be given through your IV.

  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

  • Capnography: This is a test that is done to measure how much carbon dioxide (gas) comes out from your lungs. It will help your caregiver know if your lungs are working well.

  • EEG: This test is also called an electroencephalogram. Many small pads or metal discs are put on your head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of your brain. Caregivers look at the tracing to see how your brain is working.

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

What should I know when I go home after having deep sedation?

  • Do not drive a car or use heavy equipment. An adult should drive you home and stay with you.

  • Follow your caregiver's advice about making changes to your diet or activities. Do not make important decisions for 24 hours (one day) after having deep sedation. Avoid hard exercise right after having deep sedation. Do not drink alcohol, such as beer and wine.

  • Take your medicine as ordered. Anti-nausea medicine may be given to calm your stomach and prevent vomiting (throwing up). Pain medicine may make you feel like vomiting, so pain medicine and anti-nausea medicine are often given together.

  • Use ice chips. You may suck or chew small pieces of ice to decrease your need to cough.

  • Use lip balm. Put lip balm on your lips to keep them moist and help prevent them from chapping.

When should I call my caregiver?

Call your caregiver if:

  • You have a cough or a mild headache.

  • You have a fever (high body temperature).

  • You have an upset stomach or start throwing up.

  • You have a new rash on your body.

  • You have questions or concerns about your condition, medicine, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You have a very bad headache.

  • You feel like your heart is beating too fast, or it feels like it is pounding hard.

  • You have sudden trouble breathing.

Where can I find more information?

Contact any of the following:

  • American Pain Society
    4700 W. Lake Avenue
    Glenview , IL 60025
    Phone: 1- 847 - 375-4715
    Web Address: http://www.ampainsoc.org
  • American Society of Anesthesiologists
    520 N. Northwest Highway
    Park Ridge , IL 600682573
    Phone: 1- 847 - 8255586
    Web Address: http://www.asahq.org

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Treatment options may include having certain types of procedures done. You always have the right to refuse a treatment.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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