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Intravenous sedation

If you have a private operation planned, it may involve an anaesthetic procedure, in this instance intravenous sedation. You may wish to know what this involves.
 
The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

 

 

What is the problem?

You need to be made relaxed and sleepy for an operation. Intravenous sedation is often the most suitable way of keeping you safe and comfortable for an operation.   

 

What is intravenous sedation?

Intravenous sedation is the use of drugs through a needle in a vein (a drip) to make you feel sleepy and less anxious. In fact the drugs may actually make you sleep, but not too deeply. Often the drugs make you forget what has happened.

Intravenous sedation

 

This is used when you are having minor surgery (like having a small abscess lanced) or for some tests (such as a biopsy, where a small piece of tissue is removed).

 

For surgery, the sedation is almost always used with local anaesthetic. The local anaesthetic is injected into the skin around the operation area to make it numb and pain free.

The aims

 

The aim of the sedation is to allow you to relax and not feel anxious or nervous during your operation.

 

The benefits

 

Without sedation the operation would possibly cause you anxiety, distress or pain. In addition to providing comfort the sedation also enables the surgeon to perform your operation with greater ease and safety.

 

Are there any alternatives?

 

The main alternative to intravenous sedation is a general anaesthetic, where you are completely asleep for your operation. This may not be possible if you have a medical condition that would increase the risks of a general anaesthetic. This should be discussed with your anaesthetic doctor.

 

It is often good to avoid a general anaesthetic. If the operation is minor then a local anaesthetic with intravenous sedation may be all that is needed.

 

There are other alternatives to a general anaesthetic that can be used with sedation. These avoid having a general anaesthetic at all. These are listed below:

 

  • Epidural - It may be possible to perform an epidural where the lower part of the body goes numb and is pain free. This involves placing a plastic tube next to the nerves in the spine, so that drugs can be injected, making the nerves stop working temporarily.

  • Spinal - Alternatively a single injection, like an epidural, but without putting the plastic tube in, can be used. This single injection is called a spinal. It does not last as long as an epidural.

  • Regional anaesthetic - Another method is to make individual nerves go numb temporarily. This could be your whole arm or leg. This makes a small region of the body numb, hence the name ‘regional anaesthetic’. 

 

Whether any of these alternatives are suitable, depends on the part of the body to be operated on. The length of the procedure is also important. All of these injection methods can be used with sedation into a vein to help relieve anxiety.

 

If you are to have one of these procedures there is another information leaflet that will tell you more about it.

 

Hypnosis - More recently, some patients have used hypnosis to help them during an operation. Very few people can tolerate operations with hypnosis alone, but it may assist with the relief of anxiety, when used with other nerve blocking methods. Hypnosis could be used with, or instead of, intravenous sedation.

 

Who should have it done?

 

General reasons for having sedation, are listed below:

 

  • When you feel very anxious or worried about a minor procedure or investigation. This would include a gastroscopy. This is having a camera passed down into your stomach.

  • Where the operation is short and involves a small area of the body, like a finger.

  • Where the operation is not very painful.

  • When you are too unwell to take a general anaesthetic.

  • When you are too unwell for alternative anaesthetics, like an epidural.

 

Who should not have it done?

 

If you are unwilling to have sedation and a general anaesthetic is safe, then intravenous sedation need not be performed. 

 

The only definite reason for not having sedation is an allergy to the sedating drugs. In this case they cannot be used.

 

Author: Dr Sean White FRCA. Consultant in pain and anaesthesia

© Dumas Ltd 2006

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