Procedural sedation and analgesia aftercare

After the procedure, the patient must be monitored until they are awake and obeying commands. During this time, it is common to give supplemental oxygen to prevent postprocedural hypoxia, particularly if nitrous oxide was used.

The patient can be discharged once the peak effects of all drugs administered for procedural sedation and analgesia have passed and the patient:

• has normal and stable vital signs
• has returned to an acceptable and safe level of physical and cognitive function
• can tolerate oral intake (fluids at a minimum).

On discharge, instruct the patient and their carer that for the next 24 hours the patient must:

• be in the company of a responsible adult—if the responsible adult is driving and cannot provide supervision to a child, supervision should be provided by a second adult
• avoid driving or operating heavy machinery
• not perform complex tasks where considerable judgment is required.

Warn of the possibility of bizarre dreams (particularly in children) if ketamine was administered. These dreams may persist for a few hours after discharge and settle with reassurance.

Postprocedural pain should be managed according to the general principles of acute pain.