Journal of Pain & Relief
Open Access

Review Article

Procedural Sedation and Analgesia in Emergency Department: A Review and Update

Upadhyay SP^*, Singh AK, Varma M, Rao MB and Mallick NP

Department of Anaesthesiology, NMC Hospital, Dubai, United Arab Emirates

Corresponding Author:

Surjya Prasad Upadhyay
Department of Anaesthesiology
NMC Hospital, Dubai Investments Park
Dubai, United Arab Emirates
Tel: 0097148840721
E-mail: surjya.upadhyay@nmc.ae

Received Date: August 02, 2016; Accepted Date: September 27, 2015; Published Date: September 30, 2015

Citation: Upadhyay SP, Singh AK, Varma M, Rao MB, Mallick NP (2016) Procedural Sedation and Analgesia in Emergency Department: A Review and Update. J Pain Relief 5:270. doi:10.4172/2167-0846.1000270

Copyright: © 2016 Upadhyay, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Procedural sedation and analgesia is one of the common clinical practices in the emergency department. The level of sedation must be adjusted in such a way that it allows patient to tolerate unpleasant procedures while maintaining normal physiologic reflexes and consciousness and able to understand and respond to verbal or light tactile stimulus. Although drugs used for procedural sedation has wide margin of safety but inappropriate monitoring or dosing may cause serious adverse event. Procedural sedation in emergency department is not without risk. Proper monitoring; provision of readily available access to resuscitation facility and continuous presence of trained staffs capable for airway management and providing advanced life support measure contributes reduction in adverse outcome. Pre-procedural evaluation is done to screen for suitability for procedural sedation and assesses the risk factors. Patients with full stomach, difficult airway or significant medical illness requiring more than mild sedation, alternative to procedural sedation should be considered. Clinician performing procedural sedation should have through knowledge of action, dose, side effects and antidote of commonly used sedative analgesics. Newer and innovative techniques have been evolved recently including transmucosal, Tran’s nasal, inhalation anaesthetic, patient controlled sedation, target controlled sedation. All patients after procedural sedation should be monitored in a designated recovery area and should not be discharged until they meet all the discharge criteria and while sending home, proper written discharge instruction should be provided to all.

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