Just as the history of sedation is a continuum of events and discoveries, it is important to understand that sedation itself is a continuum. The boundaries between the different levels of sedation may not always be evident to the untrained or inexperienced and progression from one level to a higher level may quickly occur as patients do not always respond predictably to any particular sedative agent, i.e., they may respond idiosyncratically. Table 1 summarizes the different levels of sedation continuum and their characteristics.
Level | Responsivness | Airways | Ventilation | Cardiovascular |
---|---|---|---|---|
Minimal | Normal | Not affected | Not affected | No change |
Moderate | Purposeful response | Open | Adequate | Maintained |
Deep | Repeated painful stimulus | May need assistance | Ventilation may be impaired | Usually maintained |
General | No response/not easily aroused | Often needs assistance | Impaired/needs support | May be impaired |
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