Updated sedative basics guide: everything you need to know about sedatives in clinical practice

As interventional procedures become more common in clinical practice, sedatives are being increasingly used to enhance patient experience, overall safety, and procedural efficacy. An appropriate sedation depth, which is crucial for patient safety, is determined according to sedative dosage, procedural stimuli, and patient status. Thus, it is important that clinicians understand the continuous nature of sedation levels.Current Concepts: Although sedation offers benefits, it also carries risks. Thus, vigilant monitoring during and after a procedure is important for preventing excessive sedation depth and related complications. Combining sedatives with analgesics, including opioids, often has a synergistic effect that necessitates a dosage reduction. Interdisciplinary guidelines for moderate sedation were recently developed to address expanding procedural scopes and patient population diversity.Discussion and Conclusion: To ensure sedation safety and success in new procedures, healthcare providers should refer to relevant studies. In cases with limited evidence, sedative dosages should be determined based on their pharmacological characteristics.

The changes of non-invasive hemoglobin and perfusion index of Pulse CO-Oximetry during induction of general anesthesia / 대한마취과학회지

BACKGROUND: We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7(R) Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane. METHODS: The laboratory hemoglobin (Hb(lab)) was measured before surgery by venous blood sampling. The SpHb and the PI was measured twice; before and after the induction of general anesthesia using sevoflurane. The changes of SpHb, Hb(bias) (Hb(bias) = SpHb - Hb(lab)), and PI before and after the induction of general anesthesia were analyzed using a paired t-test. Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hb(bias) and the PI. RESULTS: The SpHb and the PI were increased after the induction of general anesthesia using sevoflurane. There was a statistically significant change in the Hb(bias) from -2.8 to -0.7 after the induction of general anesthesia. However, the limit of agreement (2 SD) of the Hb(bias) did not change after the induction of general anesthesia. The Pearson correlation coefficient between the Hb(bias) and the PI was not statistically significant. CONCLUSIONS: During induction of general anesthesia using sevoflurane, the accuracy of SpHb measurement was improved and precision was not changed. The correlation between Hb(bias) and PI was not significant.