From the Guidelines
Moderate sedation is indicated when a patient responds purposefully to verbal commands, either alone or with light tactile stimulus. This level of sedation, also known as conscious sedation, allows patients to maintain their protective reflexes and independently maintain their airway. According to the most recent and highest quality study 1, moderate sedation is defined as a drug-induced depression of consciousness during which patients respond purposefully to verbal commands or after light tactile stimulation. The key characteristics of moderate sedation include:
- Patients respond purposefully to verbal commands or light tactile stimulation
- No interventions are required to maintain a patent airway
- Spontaneous ventilation is adequate
- Cardiovascular function is usually maintained Medications commonly used for moderate sedation include midazolam, fentanyl, or propofol. During moderate sedation, patients should be continuously monitored for vital signs, oxygen saturation, and level of consciousness. A provider skilled in airway management should be present, and resuscitation equipment should be immediately available. Moderate sedation is appropriate for many procedures, including endoscopy, cardioversion, and minor surgical procedures. The goal is to provide adequate anxiolysis and analgesia while maintaining the patient's ability to respond to stimulation, which helps ensure safety while still providing comfort during procedures, as supported by 1 and 1.
From the Research
Sedation Levels
- The level of sedation where a patient responds purposefully to verbal commands, either alone or with light tactile stimulus, is indicated as Moderate Sedation 2, 3, 4.
Characteristics of Moderate Sedation
- Moderate sedation is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands with or without light tactile stimulation 2.
- Patients under moderate sedation retain their protective airway reflexes and respond to and understand verbal communication 4.
Comparison with Other Sedation Levels
- Moderate sedation provides a safety margin when compared with deep sedation and general anesthesia 2.
- Deep sedation is characterized by a patient's inability to respond purposefully to verbal commands, even with light tactile stimulus 3, 5, 6.
- General anesthesia is a state of complete unconsciousness, where patients do not respond to verbal commands or tactile stimuli 2.