Oral sedation for epidural steroid injection

Education and training requirements to administer sedation vary by state. The ADA has set forth general sedation guidelines that have been adopted or modified by many states. There are typically dosing limitations involved with anxiolysis , usually a single dose the day of treatment not to exceed the maximum recommended dose (MRD) of the medication in order to achieve the intended level of sedation. However, these sedation laws vary from state to state. Anxiolysis protocols are designed to treat healthy ASA I & II patients ages 18 and up for one to four hours of treatment. Some states now require a permit even for nitrous oxide administration and/or anxiolysis . [8]

Patients under general anesthesia must undergo continuous physiological monitoring to ensure safety. In the US, the American Society of Anesthesiologists (ASA) have established minimum monitoring guidelines for patients receiving general anesthesia, regional anesthesia, or sedation. This includes electrocardiography (ECG), heart rate, blood pressure, inspired and expired gases, oxygen saturation of the blood (pulse oximetry), and temperature. [5] In the UK the Association of Anaesthetists (AAGBI) have set minimum monitoring guidelines for general and regional anesthesia. For minor surgery, this generally includes monitoring of heart rate , oxygen saturation , blood pressure , and inspired and expired concentrations for oxygen , carbon dioxide , and inhalational anesthetic agents. For more invasive surgery, monitoring may also include temperature, urine output, blood pressure, central venous pressure , pulmonary artery pressure and pulmonary artery occlusion pressure , cardiac output , cerebral activity , and neuromuscular function. In addition, the operating room environment must be monitored for ambient temperature and humidity, as well as for accumulation of exhaled inhalational anesthetic agents, which might be deleterious to the health of operating room personnel. [6]

Oral sedation for epidural steroid injection

oral sedation for epidural steroid injection

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