Skip to main content
Anesthesia Progress logoLink to Anesthesia Progress
. 1998 Summer;45(3):117–126.

Patient-Controlled Sedation

Chandra Rodrigo
PMCID: PMC2148957  PMID: 19598717

Abstract

Patient-controlled sedation was utilized in patients aged 15 to 85 yr who were undergoing surgery under local or regional anesthesia. Midazolam, propofol, and methohexitone were used, either by themselves or in combination with fentanyl or alfentanil. Sedation was mild to moderate in the majority of patients, and operating conditions were good. The sedation method provided patients the ability to control the sedation and to vary the degree of sedation according to the environment and to the stress of the procedure. Sedation of the elderly, which tends to be problematic, was made easy using this method, and the elderly patients appeared to enjoy the option. The problems encountered were oversedation, respiratory depression, pain during injection, and postural hypotension.

Keywords: Patient-controlled sedation, Review

Full text

PDF
117

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cook L. B., Lockwood G. G., Moore C. M., Whitwam J. G. True patient-controlled sedation. Anaesthesia. 1993 Dec;48(12):1039–1044. doi: 10.1111/j.1365-2044.1993.tb07521.x. [DOI] [PubMed] [Google Scholar]
  2. Dell R. A review of patient-controlled sedation. Eur J Anaesthesiol. 1996 Nov;13(6):547–552. doi: 10.1046/j.1365-2346.1996.00042.x. [DOI] [PubMed] [Google Scholar]
  3. Galletly D. C., Short T. G., Forrest P. Patient-administered anxiolysis--a pilot study. Anaesth Intensive Care. 1989 May;17(2):144–150. doi: 10.1177/0310057X8901700204. [DOI] [PubMed] [Google Scholar]
  4. Ganapathy S., Herrick I. A., Gelb A. W., Kirkby J. Propofol patient-controlled sedation during hip or knee arthroplasty in elderly patients. Can J Anaesth. 1997 Apr;44(4):385–389. doi: 10.1007/BF03014458. [DOI] [PubMed] [Google Scholar]
  5. Grattidge P. Patient-controlled sedation using propofol in day surgery. Anaesthesia. 1992 Aug;47(8):683–685. doi: 10.1111/j.1365-2044.1992.tb02390.x. [DOI] [PubMed] [Google Scholar]
  6. Hamid S. K., McCann N., McArdle L., Asbury A. J. Comparison of patient-controlled sedation with either methohexitone or propofol. Br J Anaesth. 1996 Dec;77(6):727–730. doi: 10.1093/bja/77.6.727. [DOI] [PubMed] [Google Scholar]
  7. Hamid S. K., Wong P. K., Carmichael F., White K., Asbury A. J. A novel device for patient-controlled sedation: laboratory and clinical evaluation of the Baxter Intermate LV250 infusor and patient-control module. Anaesthesia. 1996 Feb;51(2):145–150. doi: 10.1111/j.1365-2044.1996.tb07702.x. [DOI] [PubMed] [Google Scholar]
  8. Herrick I. A., Craen R. A., Gelb A. W., McLachlan R. S., Girvin J. P., Parrent A. G., Eliasziw M., Kirkby J. Propofol sedation during awake craniotomy for seizures: electrocorticographic and epileptogenic effects. Anesth Analg. 1997 Jun;84(6):1280–1284. doi: 10.1097/00000539-199706000-00020. [DOI] [PubMed] [Google Scholar]
  9. Herrick I. A., Craen R. A., Gelb A. W., Miller L. A., Kubu C. S., Girvin J. P., Parrent A. G., Eliasziw M., Kirkby J. Propofol sedation during awake craniotomy for seizures: patient-controlled administration versus neurolept analgesia. Anesth Analg. 1997 Jun;84(6):1285–1291. doi: 10.1097/00000539-199706000-00021. [DOI] [PubMed] [Google Scholar]
  10. Herrick I. A., Gelb A. W., Nichols B., Kirkby J. Patient-controlled propofol sedation for elderly patients: safety and patient attitude toward control. Can J Anaesth. 1996 Oct;43(10):1014–1018. doi: 10.1007/BF03011902. [DOI] [PubMed] [Google Scholar]
  11. Kaufman E., Davidson E., Sheinkman Z., Magora F. Comparison between intranasal and intravenous midazolam sedation (with or without patient control) in a dental phobia clinic. J Oral Maxillofac Surg. 1994 Aug;52(8):840–844. doi: 10.1016/0278-2391(94)90232-1. [DOI] [PubMed] [Google Scholar]
  12. Loper K. A., Ready L. B., Brody M. Patient-controlled anxiolysis with midazolam. Anesth Analg. 1988 Nov;67(11):1118–1119. [PubMed] [Google Scholar]
  13. Osborne G. A., Rudkin G. E., Curtis N. J., Vickers D., Craker A. J. Intra-operative patient-controlled sedation. Comparison of patient-controlled propofol with anaesthetist-administered midazolam and fentanyl. Anaesthesia. 1991 Jul;46(7):553–556. doi: 10.1111/j.1365-2044.1991.tb09654.x. [DOI] [PubMed] [Google Scholar]
  14. Osborne G. A., Rudkin G. E., Jarvis D. A., Young I. G., Barlow J., Leppard P. I. Intra-operative patient-controlled sedation and patient attitude to control. A crossover comparison of patient preference for patient-controlled propofol and propofol by continuous infusion. Anaesthesia. 1994 Apr;49(4):287–292. doi: 10.1111/j.1365-2044.1994.tb14175.x. [DOI] [PubMed] [Google Scholar]
  15. Owen H., Mather L. E., Rowley K. The development and clinical use of patient-controlled analgesia. Anaesth Intensive Care. 1988 Nov;16(4):437–447. doi: 10.1177/0310057X8801600409. [DOI] [PubMed] [Google Scholar]
  16. Pac-Soo C. K., Deacock S., Lockwood G., Carr C., Whitwam J. G. Patient-controlled sedation for cataract surgery using peribulbar block. Br J Anaesth. 1996 Sep;77(3):370–374. doi: 10.1093/bja/77.3.370. [DOI] [PubMed] [Google Scholar]
  17. Park G. R. Patient controlled co-sedation. Anaesthesia. 1996 Jul;51(7):706–707. doi: 10.1111/j.1365-2044.1996.tb07864.x. [DOI] [PubMed] [Google Scholar]
  18. Park W. Y., Watkins P. A. Patient-controlled sedation during epidural anesthesia. Anesth Analg. 1991 Mar;72(3):304–307. doi: 10.1213/00000539-199103000-00005. [DOI] [PubMed] [Google Scholar]
  19. Rodrigo C., Chow K. C. A comparison of 1- and 3-minute lockout periods during patient-controlled sedation with midazolam. J Oral Maxillofac Surg. 1995 Apr;53(4):406–411. doi: 10.1016/0278-2391(95)90712-2. [DOI] [PubMed] [Google Scholar]
  20. Rodrigo C., Chow K. C. Patient-controlled sedation: a comparison of sedation prior to and until the end of minor oral surgery. Aust Dent J. 1996 Jun;41(3):159–163. doi: 10.1111/j.1834-7819.1996.tb04847.x. [DOI] [PubMed] [Google Scholar]
  21. Rodrigo M. R., Tong C. K. A comparison of patient and anaesthetist controlled midazolam sedation for dental surgery. Anaesthesia. 1994 Mar;49(3):241–244. doi: 10.1111/j.1365-2044.1994.tb03431.x. [DOI] [PubMed] [Google Scholar]
  22. Rudkin G. E., Maddern G. J. Peri-operative outcome for day-case laparoscopic and open inguinal hernia repair. Anaesthesia. 1995 Jul;50(7):586–589. doi: 10.1111/j.1365-2044.1995.tb15108.x. [DOI] [PubMed] [Google Scholar]
  23. Rudkin G. E., Osborne G. A., Curtis N. J. Intra-operative patient-controlled sedation. Anaesthesia. 1991 Feb;46(2):90–92. doi: 10.1111/j.1365-2044.1991.tb09345.x. [DOI] [PubMed] [Google Scholar]
  24. Rudkin G. E., Osborne G. A., Finn B. P., Jarvis D. A., Vickers D. Intra-operative patient-controlled sedation. Comparison of patient-controlled propofol with patient-controlled midazolam. Anaesthesia. 1992 May;47(5):376–381. doi: 10.1111/j.1365-2044.1992.tb02216.x. [DOI] [PubMed] [Google Scholar]
  25. Tsunoda K. [The dosage of sedative was reduced by patient-controlled sedation during epidural anesthesia]. Masui. 1995 Jan;44(1):73–78. [PubMed] [Google Scholar]
  26. Uyar M., Uyar M., Uğur G., Bílge S., Ozyar B., Ozyurt C. Patient-controlled sedation and analgesia during SWL. J Endourol. 1996 Oct;10(5):407–410. doi: 10.1089/end.1996.10.407. [DOI] [PubMed] [Google Scholar]
  27. Zacharias M., Hunter K. M., Luyk N. H. Patient-controlled sedation using midazolam. Br J Oral Maxillofac Surg. 1994 Jun;32(3):168–173. doi: 10.1016/0266-4356(94)90103-1. [DOI] [PubMed] [Google Scholar]

Articles from Anesthesia Progress are provided here courtesy of American Dental Society of Anesthesiology

RESOURCES