Safe sedation practice for surgeons

Sedation may facilitate the acceptance of surgery under local anaesthesia, and improve the patient's experience. However, surgeons should be aware that there is good evidence that sedation has the potential to harm patients. Some authorities believe that patients' protective reflexes are impaired at any level of sedation. Sedation merges into anaesthesia in a continuum of loss of consciousness. All surgeons should understand the definition of ‘conscious sedation’, and be aware of the concepts of ‘deep sedation’ and ‘monitored anaesthesia care’, which are prevalent in the USA. This paper discusses current sedation guidelines in the particular speciality areas where surgeons may be involved, the evidence for patient complications with sedation, and safe sedation practice.