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.
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