Sedation definition

Adults - 25 to 50 mg at bedtime for nighttime sedation. Doses of 50 mg provide sedation and relieve apprehension during early stages of labor. When labor is definitely established, 25 to 75 mg may be given IM or IV with an appropriately reduced dose of any desired narcotic. If necessary, promethazine injection with a reduced dose of analgesic may be repeated once or twice at 4-hour intervals. Do not exceed 100 mg per 24 hours for patients in labor. 

In psychomotorically retarded patients, many clinicians prefer to use a less sedating drug (e.g., an SSRI, venlafaxine, bupropion, or desipramine), but definitive evidence is lacking. 

The Council of Ten, its three chiefs, the three state inquisitors, the doge—I had no idea what political currents were flowing and who was on whose side. This was definitely not a moment to create waves. I replaced my bonnet at a more sedate angle. Humble was in. 

In an open 12-week study of ziprasidone in 12 patients with Parkinson s disease and psychosis, two withdrew because of adverse effects one had increased diurnal sedation on day 5 and the other had deterioration of gait at 1 week (7C). The other 10 patients reported significant improvement in psychiatric symptoms and no deterioration in motor symptoms. The small sample size and lack of a control group precluded definitive conclusions. 

Sedation and amnesia without analgesia are provided by midazolam i.v. or, less commonly nowadays, diazepam. These drugs can be used alone for procedures causing mild discomfort, e.g. endoscopy, and with a local anaesthetic where more pain is expected, e.g., removal of impacted wisdom teeth. Benzodiazepines produce anterograde, but not retrograde, amnesia. By definition, the sedated patient remains responsive and cooperative. (For a general account of benzodiazepines and the competitive antagonist flumazenil, see Ch. 19.)... 

Drug dose is a critical issue in determining unwanted daytime sedation. Thus, 5 mg of nitrazepam produces few effects compared with 10 mg. Similarly, large doses (over 0.5 mg) of triazolam produce definite hangover effects. 

It is not essential to scan everyone with FEP. Threshold for scanning decreases with age, e.g. consider scanning over-40s definitely scan over-65s with FEP. Check local protocols. May need sedation to allow urgent scan - judge carefully, as you still need to assess MSE ... 

Some authors recommend using MR imaging to delineate the anatomy of the inner genitalia prior to definitive surgical repair of the cloacal malformation (Metts et al. 1997 Tolete-Velcek et al. 1989). We, however, have never obtained much additional information from MR imaging and do not believe that MR imaging, which requires sedation of the patients, should be performed routinely during the work-up of cloacal malformation. 

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