Procedural Sedation and Analgesia (Adults)

Procedural Sedation and Analgesia (PSA) is a method of administering a sedative and sometimes analgesic (painkiller) when a patient is undergoing a procedure which can be uncomfortable and/or painful. Most procedures requiring PSA are carried out at the Department of Diagnostic and Interventional Imaging (DDII) or at Day Surgery.

You may receive PSA as an inpatient or outpatient. If you receive PSA as an outpatient, you are allowed to go home on the same day of your procedure. You do not need to stay overnight in the hospital.

The sedative is usually given directly into the vein.

Yes. A minimum of six hours of fasting is necessary before the appointment time, or as instructed by the doctor or nurse.

Please ensure that the last meal is light: plain milk/milo (maximum one cup) with plain biscuits or plain bread (maximum two pieces). Heavy and oily meals can cause vomiting and the food can go into the lungs causing life-threatening complications.

• Patients with known allergy to the medicine used for PSA
• Patients who have taken a meal less than six hours before PSA
• Patients with an ongoing respiratory tract infection
• Patients with some medical conditions deemed inappropriate for sedation
  
  

No. We will reschedule another appointment in 2 weeks’ time after recovery from the acute illness.

Common medications used are Midazolam and Fentanyl.

• Fluctuations in vital signs are most frequently seen following intravenous administration.
  They include:
  - Decreased rate and depth of breathing
  - Drop in blood pressure and heart rate
  
• Hiccups
• Nausea and vomiting
• Coughing
• Headache
• Prolonged drowsiness
  
  

In general, PSA is well tolerated and patients are monitored closely throughout the procedure. If any side effects occur, it will be treated immediately.

Advice after PSA
You may feel drowsy for a few hours following PSA.

You must have an escort to take you home if you have had a day surgery procedure.

You can resume your diet when you recover fully from PSA.

Pain relief is an important part of the procedure.

In some procedures, local anaesthetics are used to provide a satisfactory level of analgesia. This could be used alone to carry out the procedure without requiring additional medication.

Oral painkillers, if prescribed, should be taken as instructed.

For the subsequent 24 hours after PSA, please note the following:

• Do not consume alcohol
  
• Do not use any sedatives or tranquilisers
• Do not handle any machinery
• Do not handle any sharp items
• Do not drive
• Do not go to the toilet unattended
  
  

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