Monitoring

Monitoring required for procedural sedation and analgesia depends on the level of sedation planned and the patient’s comorbidities. At a minimum, monitor:

• oxygen saturation and pulse rate using continuous pulse oximetry
• blood pressure
• pain experienced; see Assessing a patient with pain
• behavioural responses (eg responses to stimulation or verbal commands)
• sedation scores; see An example of a sedation scoring system.

For conscious and deep sedation, continuously monitor respiratory rate and electrocardiogram. For deep sedation, end-tidal partial pressure of carbon dioxide must also be continuously monitored to aid early detection of inadvertent respiratory depression. Carbon dioxide monitoring is strongly advised for conscious sedation, to aid early detection of progression to deep sedation.

For further detail, see the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine Guideline on sedation and/or analgesia for diagnostic and interventional medical, dental or surgical procedures [URL].