Talk:Procedural sedation and analgesia

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 October 2019 and 23 November 2019. Further details are available on the course page. Student editor(s): Amucsfwiki. Peer reviewers: ALKNOPTR.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 02:44, 18 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 November 2018 and 14 December 2018. Further details are available on the course page. Student editor(s): Smithdu92. Peer reviewers: Musc2016SC.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 07:14, 17 January 2022 (UTC)

Sources

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ija/vol11n1/sedation.xml

--Doc James (talk) 22:58, 13 December 2008 (UTC)

The American Society of Anesthesiologists defines the continuum of sedation as follows

And then there follows a table that makes no mention of Procedural sedation (or "conscious sedation" either). It's pretty unclear what that table is there for or what it's trying to tell us without some indication of where Procedural sedation comes on the continuum; is it the same as moderate sedation, or deep sedation, or somewhere in between? My first guess was "in between", but then the history section suggests that it's actually just the same as "conscious sedation". It's confusing, a little explicit clarification would be much appreciated. 82.6.108.62 (talk) 01:51, 11 November 2011 (UTC)

Remifentanyl

Poorly studied doi:10.1136/emermed-2016-206129 JFW | T@lk 13:43, 20 April 2017 (UTC)

Work Plan

This article has a decent base of headers. However, it is obviously lacking a lot of information. I think one area that especially need more content are the agents including their class, how they work, reasoning behind selecting certain ones, etc. I did notice that there was a work cited from the year 2000 and that the drug dexmedetomidine, a relatively new drug, was not mentioned.Overall, I assume that the agents will have the most information and encompass the majority of my time and content. This part will force me to be as concise as possible. The article also needs a better definition and explanation of procedural sedation, its uses, and the overall process. One thing that has already been addressed in the talk page is the lack of explanation associated with the ASA chart about levels of sedation. This will be explained in the context of procedural sedation. I think a section should be dedicated to the entire process and the techniques that are used. Additionally, there needs to be more about the special considerations, complications, and when you can discharge after administering this kind of anesthesia. Complications is an another area I could see requiring more time and effort. The article currently mentions that it depends on the agent used, which is true, but fails to give any more detail outside of that. I do understand that there is a possibility my plan changes as I do more research about this topic and anticipate that is will. The embedded links will be used where I see appropriate. For example, the drugs that are used are very well studied and there is information about them that go beyond the scope of what this page will entail. It is also possible that images will be utilized to discuss the airway or pharmacology.

My initial research will consist of Uptodate and Lexicomp to enhance my general knowledge. This will give me a better understanding of procedural sedation which will give me a beer idea of what content is important, what headers will be needed, and if any outdated information is currently in the article. Basics of Anesthesia commonly referred to as "Baby Millers" will probably be of use as it is the concise version of Miller's Anesthesia the major textbook in the field. Additionally, Access Medicine and Clinical key will help search textbooks by keyword. Obviously, whatever I use will be the most up to date information all from reliable sources. Moreover, I will need to review the citations currently in the article as several have the possibility to be outdated.

One issue that always has to be addressed when providing medical information to the general public is jargon. I will avoid jargon by constantly reading my edits, utilizing plain text websites such as Univ of Michigan, and having a non-medical persons read the article periodically. If I do find jargon, I will utilize the plain text websites will be useful to help find alternative words. Occasionally, it will be necessary to use medical jargon. When this occurs providing appropriate definitions will be required.

Current header ideas:

Introduction: give brief overview of what procedural sedation is. Can utilize the ASA chart. Will also considering adding the medical uses to this.

Process: talk through what happens with procedural sedation

Agents: explain medications used by class.

complications: discuss potential complications of this type of sedation and to individual agents. can also discuss safety and reducing risk in this section

Contraindications/special considerations: talk about the groups of people that might be at high risk or can not be given this sedation

Discharge criteria: discuss when a patient is safe to be discharged and what is normal after discharge — Preceding unsigned comment added by Smithdu92 (talk • contribs) 20:14, 19 November 2018 (UTC)

Discharge Criteria

There are a few criteria for discharging a patient that has undergone procedural sedation. The recovery time for a patient to be ready for discharge varies but is typically 60-120 minutes. Criteria: 1)Patient must be stable from a cardiovascular standpoint and have an open airway. 2)The patient should be easy to arouse and have intact reflexes such as a gag and cough reflex. 3)He/She should be approaching their baseline level of talking and sitting up. 4)The patient should be properly hydrated. 5)In a special population patient, such as a very young or mentally handicapped patient, he/she should be about as responsive as they were pre-sedation.

— Preceding unsigned comment added by Smithdu92 (talk • contribs) 03:29, 28 November 2018 (UTC)

References

Article Assessment (peer review)

Excellent thought to expand this topic as the possibility of undergoing PSA for a procedure during an individual’s lifetime is relatively high. Everything in the article was relevant to the topic as well as being relatively neutral with the exception of the “Complications” section. The single sentence listed seems to make it more of a token comment and underrepresents the issue. There should be more information representing this topic in order to properly discuss it; especially in the context of the multitude of provider-types and the ongoing stratification of healthcare due to rising costs. There are also citation links for references “4” and “10” that do not work, but the references themselves were appropriate and reliable. As far as more information for the article, I think adding additional information about why there is fasting recommended before sedation would be helpful for a patient to understand and would promote compliance. Additionally, the topics of “Safety,” “Controversies,” “History” and the subtopic “Monitoring” could use some extra detail. With these items being such broad topics, there should be easily accessible and useful information. It won’t take much time to make this article complete and a good resource. To that end, a “See Also” and/or “External Links” section(s) would be a good reference, as well as covering the overlap this topic has with other Wikipedia articles. Musc2016SC (talk) 22:50, 7 December 2018 (UTC)

UCSF Wiki Nov 2019 - Work Plan

Hello! I will be editing the Procedural Sedation and Analgesia wikipedia page as part of a course through UCSF.
My work plan for the month is as follows:
- Divide section for sedative agents and for analgesic agents
- Add updated information regarding mechanism of action, onset and duration times, properties, adverse effects, and any reversal agents available for each sedative and analgesic agent
- Update safety & monitoring section
- Add section for contraindications
- Review article for medical jargon, and change into more public-friendly language
- Reorder sections in the article to improve coherence and flow

Timeline:
10/29-11/1: Develop work plan, collect and review resources
11/1: Wiki WIP #1
11/6: Wiki WIP #2
11/12: Wiki WIP #3 (tentative date)
11/19: Wiki WIP #4
11/21: Finalize article edits
11/22: Last day of course, wrap up session
— Preceding unsigned comment added by Amucsfwiki (talk • contribs) 20:30, 31 October 2019 (UTC)

Sounds good. Re order: see the medical manual of style and the text about the the order of sections in particular. Graham87 03:47, 1 November 2019 (UTC)

UCSF Wiki Peer Review

Thank you for letting me edit your reviews on the PSA.

I thought the information you included was very important for the public and was written in use friendly language. I made some minor edits on sentence structure to make the paragraphs flow more easily. My only recommendation at this moment is that you cite your references.

Also, in the medical uses section, you can include eye surgery and in the section on sedative agents, do you think it would be a good idea to discuss thiopentone? For the part on complications, it might be a good opportunity to remind readers of the importance of remembering what they are allergic too.

— Preceding unsigned comment added by 2607:f598:bb92:fa00:97cb:afbb:444b:20cd (talk) 05:25, 19 November 2019 (UTC)

Merger proposal

I propose merging Sedoanalgesia into Procedural sedation and analgesia. I think the content in Sedoanalgesia can easily be included in this article, and a merger would not cause any article-size or weighting problems in Procedural sedation and analgesia. Dimitribiemond (talk) 11:02, 29 November 2021 (UTC) @Amucsfwiki, Graham87, and Lizia7: Please help me check if this merger could make sense. Dimitribiemond (talk) 11:02, 29 November 2021 (UTC)

I know nothing about this topic so I have no idea. Graham87 14:51, 29 November 2021 (UTC)

Agree Anesth Earth (talk) 10:14, 11 October 2023 (UTC)

 Comment:I think "twilight anesthesia" should also be merged into this article. Anesth Earth (talk) 09:50, 15 December 2023 (UTC)