Sedation is a method doctors use to make patients feel relaxed and comfortable during specific treatments. When patients are under conscious sedation, they wake up easily and feel calm. At the other end of the sedation continuum, general anesthesia allows patients to fall completely asleep during the procedure. Is sedation something patients should worry about?
Preoperative anxiety: where does it come from?
Preoperative anxiety is a shared experience. It’s worth noting that about 36% of adults have some degree of fear of dental visits. The reason why people fear medical procedures depends on age, gender and other factors such as fear of surgery, separation from their family, financial loss, postoperative pain or even fear of death. However, it mainly stems from the patient’s ability to understand the process that takes place during sedation. Healthcare professionals should explain the benefits to patients before any use of sedatives.
Although there is always a risk when receiving anesthesia, it is usually safe when administered by an experienced healthcare professional. Practical medical knowledge and skills are required for the basics of sedation practice. Hence, safe sedation training makes healthcare professionals experts in sedation best practices. The following text debunks common misconceptions about sedation:
Myth #1: Long-term cognitive impairment
Sedation is generally safe for all eligible patients. Concerns about sedation causing long-term problems with cognitive functioning are unfounded. The correct choice of sedation strategy is crucial to avoid any side effects. The risk of cognitive impairment is also greater in the elderly and patients with pre-existing neurological disorders. These patients should be carefully screened before sedation.
Myth #2: Complete or partial paralysis
Drug-induced paralysis may be possible through deep sedation. This side effect can occur if the dosage is too high, but this is rare. Residual paralysis after general anesthesia is also a complication that can be avoided by careful management.
Myth #3: Feeling pain during surgery
Can you still feel pain under anesthesia? Normally this should not be possible if sedation is administered correctly. In rare cases, sedatives can be unpredictable or ineffective.
It is critical that healthcare providers closely monitor patients during and after sedation to ensure they have used the correct dosage and sedative. Following proper protocols will ensure patient safety and prevent any complications.
Understanding how sedation works
Sedation works on the central nervous system to slow brain activity and suppress the transmission of signals between nerve cells. Sedative drugs target brain receptors, such as GABA receptors, which are responsible for inhibitory neurotransmission. These are the 4 types of sedation:
- Minimal anesthesia. The patient remains awake but relaxed. It is suitable for dental procedures and minor operations.
- Moderate sedation. It is also called conscious sedation; the patient undergoes sedation to a moderate level, allowing him to respond to verbal commands. Medical professionals often use this sedation technique for endoscopic procedures and diagnostic imaging tests such as MRI or CT scans.
- Deep sedation. It involves the patient being between consciousness and unconsciousness, resulting in a limited response to stimuli. This type of sedation is intended for invasive surgeries, such as orthopedic or abdominal procedures.
- Anesthesia. The patient is completely unconscious and cannot feel pain or respond to any stimulus. Healthcare professionals use it for complex procedures and major surgeries such as open heart surgery, brain surgery or organ transplants.
Techniques and exercises to calm yourself down
Being anxious or worried about something is a normal part of life. Everyone gets upset or nervous, but fear or anger should not completely take over. Calming down in the moment is often difficult, but there are some strategies that can help you manage your emotions and feelings. Consider trying one of these calming tactics when you’re feeling anxious or angry:
To breathe
Naturally, you take a deep breath or sigh when you get emotionally triggered. Breathing exercises and mindfulness techniques calm the nervous system, which in turn controls the body’s involuntary functions. Controlled breathing or deliberately copying a relaxed pattern causes physiological changes. These include slowing the heart rate, lowering the levels of stress hormones in the blood and lowering high blood pressure.
A simple breathing exercise, for example, is diaphragmatic abdominal breathing. Sit or lie down somewhere quietly. Place one hand on the chest and the other above the navel. Then you inhale deeply through your nose, imagining this breath flowing through the body, causing the abdomen to rise naturally. Then concentrate on the difference in movement between the hands. Exhale through the mouth. You should feel the opposite movement for the hands. You can repeat this for up to ten minutes so that the fear disappears.
Progressive muscle relaxation
The body’s response to stress is often muscle tension which tends to cause pain or discomfort. These muscles tell the body that there is stress, leading to a progressive vicious cycle.
Participating in muscle relaxation activities can help you relax muscles that are tense due to your anxiety.
To do progressive muscle relaxationFirst, you tighten certain muscle groups one by one. During a muscle relaxation exercise, you should notice a change in how that part of the body feels. As you do this, tension and overall stress should be reduced, leaving the area feeling loose and relaxed. You can then move on to other parts of the body.
Affirmations
Some people believe that stress starts in the mind. While that is still a topic of debate for many researchers, the stress response does indeed begin in the brain. So the more nervous our thoughts are, the more stressed the body becomes. Avoiding these unhelpful and irrational thoughts is said to be beneficial for reducing anxiety. A useful technique to minimize discomfort and worry is to say affirmations.
Affirmations are positive statements or beliefs that people repeat to themselves because they resonate with them. When our minds focus on these types of optimistic statements instead of being irrational, it can result in improved self-esteem and less stress and anxiety. The psychology behind affirmations is rooted in cognitive behavioral therapy. It reinforces positive behavior and beliefs and counteracts negative thinking and associated actions.
Conclusion
Healthcare professionals can reduce preoperative anxiety by identifying and addressing the causes. Stress-free sedation is possible with thorough pre-operative education, customized sedation plans and understanding conversations. Patients can use affirmations, muscle relaxation, positive thoughts and breathing exercises to bring calm and reduce stress.