Introduction
The word sedation comes from the Latin word sedare, which means to soothe or calm. This already shows what is meant by medical sedation. The affected person is supposed to be calmed down by medication and his stress, physically and mentally, is reduced.
For this effect, sedatives, i.e. sedating drugs, must attenuate the central nervous system. In contrast to general anesthesia, the affected person normally breathes on his own and can often be awakened. Sedation can also be supplemented by painkillers, in technical terms analgesics.
This is then referred to as analgosedation. The most common sedatives are benzodiazepines and antidepressants. Sedation is used for sedation before and during medical procedures, such as colonoscopies and dental surgery, and also for sedation in cases of mental illness.
Intensive care patients are also often sedated, as otherwise they would not be able to withstand the stress of intensive care. Long-term use of sedatives can lead to habituation and require larger amounts of the medication. The sedative effect of sedation can dampen the respiratory drive and circulation to such an extent that drug therapy and monitoring may be necessary. In some cases, sedatives lead to paradoxical conditions, i.e. the affected persons become restless.
In which areas is sedation used?
Sedation has very different applications, all of which require sedation of the affected person. Before operations, many patients receive premedication from the anesthetist. This is a sedative drug in a low dose, which reduces tension and anxiety before the operation.
During a medical procedure under regional anesthesia, anxious or restless patients may also be given sedative medication so that they are not consciously aware of the procedure. Examples of such procedures or examinations are colonoscopies and dental surgery. Both procedures do not have to be performed under general anesthesia, but they are very stressful for the patient.
In intensive care units, patients are often sedated in order to create tolerance for ventilation. In addition, stress and restlessness have a negative effect on the recovery of intensive care patients and should therefore be avoided. Another area of application for sedation is the sedation of mentally ill persons.
Sedation may be necessary in both acute psychosis and suicidal situations. Sedatives are also used in so-called qualified alcohol withdrawal to reduce withdrawal symptoms. For many people, a visit to the dentist is associated with great anxiety and stress.
In most procedures, a local anaesthetic is the only anaesthetic that the patient receives. Although it eliminates the pain, it does not reduce the patient’s consciousness. Affected patients experience the entire procedure.
The sounds and pressure in the mouth area, as well as the taste of blood can make the patient uneasy and thus make the dentist’s work more difficult. Particularly anxious patients, but also children, people with dementia or mentally impaired persons can be additionally calmed with sedative medication. If medically necessary, this sedation is also paid for by the health insurance companies.
This is especially true for children and otherwise incapable patients. After a dental procedure under sedation, the patient should be picked up and not be left alone in traffic for the rest of the day. Depending on the length of the procedure, different drugs are used for sedation.
Sedatives are not painkillers, so the patient should be given additional painkillers and receive them before the anaesthesia subsides. The surgical removal of wisdom teeth is a relatively large dental procedure. The removal can also be done only under regional anesthesia, which, however, means a lot of stress for the body and is therefore performed in two appointments.
Many dentists recommend sedation for the simultaneous removal of all four wisdom teeth in order to reduce stress both physically and mentally. For this purpose, the patient is injected with a sedative, usually benzodiazepines, through a venous access. In this case, sedation is only paid for by health insurance companies in the case of minors.
In the past, many patients have described colonoscopy as a terrible experience, which has led to much fear of the procedure. Today, the reports of experience after colonoscopies are much more positive and those affected report that they slept through the procedure. This is due to the sedation that is almost always performed today.Those affected hardly notice the sometimes painful procedure and are much calmer.
The sedation for colonoscopies is usually covered by health insurance companies. MRI is one of the imaging procedures that doctors can use to obtain an overview of certain organs. The examination is completely painless.
During an MRI scan, however, the patient must lie very still in order to avoid blurring of the image. Since children and mentally impaired persons often cannot manage this lying still, sedation can be used in these cases. People with a fear of confined spaces may also require sedation. MRIs are frequently performed, especially in children, as they do not cause radiation exposure.
