Procedural Sedation

Procedural Sedation

Midland Conscious Sedation was set up in 2017 to provide a safe, effective, high quality sedation service for patients undergoing treatment in healthcare clinics in Birmingham. We only use Consultant anaesthetists trained in intravenous sedation techniques with Advanced Life Support accreditation.

The group has provided procedural sedation for more than 3,000 patients undergoing a range of fertility, plastic surgical and general surgical treatments. The sedation technique is built on a platform of target-controlled infusions of propofol, intravenous benzodiazepines and short-acting opioids.
The benefits of procedural sedation are considerable:

1. Improved patient experience with rapid onset and offset of action, low levels of postoperative nausea and vomiting and early discharge home;

2. Cost effective with increased patient throughput, direct discharge to ward based care and low levels of conversion from day case to overnight stay.

We are continually exploring ways to improve our service and in November 2021 introduced Remimazolam a novel, ultrashort acting benzodiazepine into our procedural sedation technique. This agent is best suited to procedures lasting under 60 minutes and is used instead of midazolam. It delivers even faster sedation onset and offset of action.

We were the first clinicians to use this drug in the UK and our experience has been presented at various meetings over the last 6 months including the Euroanaesthesia Congress held in Milan in June 22.

Midland Conscious Sedation has focussed on developing services at stand-alone clinics for the last 5 years. Our experience is readily transferable to the hospital setting and we are now working towards introducing similar services in the hospital environment.

Information

Conscious Sedation is "a technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation..." - AoMRC (2013)

Deep Sedation refers to "a state where the patient cannot easily be aroused but responds purposefully to repeated or painful stimulation... the ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patient airway and spontaneous ventilation may be inadequate" - Anesthesiology (2018)

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