Sedation Continuum

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.

Table 1. The Sedation Continuum.
LevelResponsivnessAirwaysVentilationCardiovascular
MinimalNormalNot affectedNot affectedNo change
ModeratePurposeful response OpenAdequateMaintained
DeepRepeated painful stimulusMay need assistanceVentilation may be impairedUsually maintained
GeneralNo response/not easily arousedOften needs assistanceImpaired/needs supportMay be impaired