Recent advances in patient-controlled sedation
- 1 December 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion In Anesthesiology
- Vol. 21 (6), 759-765
- https://doi.org/10.1097/aco.0b013e3283184001
Abstract
Advances in minimally invasive procedures have resulted in an increased demand for procedural sedation. Patient-controlled sedation (PCS) has been in clinical use for almost 20 years, but has not been reviewed in over 10 years. Advances in microprocessor technology, increased demand for procedural sedation in a cost-conscious environment, and the availability of readily titratable pharmacologic agents together stimulated the development of alternative sedation practices. Continued research into the neurobiology of pain perception and the placebo effect has also played a role. PCS and patient-maintained sedation, primarily with propofol, have emerged as intriguing clinical alternatives to traditional sedation based in part on extensions of traditional PCA models. PCS has been applied to a wide variety of procedures, but systems that can be applied 'off-the-shelf' are not easy to tune. New approaches to PCS may address these limitations. Better understanding of the psychology of sedation may lead to better patient acceptance of PCS.Keywords
This publication has 37 references indexed in Scilit:
- Individual Differences in the Effects of Perceived Controllability on Pain Perception: Critical Role of the Prefrontal CortexJournal of Cognitive Neuroscience, 2007
- Neurobiological Substrates of DreadScience, 2006
- The subjective experience of pain: Where expectations become realityProceedings of the National Academy of Sciences, 2005
- Pain model and fuzzy logic patient-controlled analgesia in shock-wave lithotripsyMedical & Biological Engineering & Computing, 2002
- Relaxation music decreases the dose of patient-controlled sedation during colonoscopy: A prospective randomized controlled trialGastrointestinal Endoscopy, 2002
- Patient-controlled sedation using propofol: randomized, double-blind dose refinementEuropean Journal of Anaesthesiology, 1999
- The development of ‘Diprifusor’: a TCI system for propofolAnaesthesia, 1998
- Development of the technology for ‘Diprifusor’ TCI systemsAnaesthesia, 1998
- Fundamentals of feedback control: PID, fuzzy logic, and neural networks.Journal of Clinical Anesthesia, 1997
- Intra‐operative patient‐controlled sedationAnaesthesia, 1991