What is Conscious Sedation (CS)?
Conscious sedation (CS) is a technique used to help you to relax, and reduce anxiety and pain during treatment. It is an alternative to local anaesthetic (LA). CS is highly suited to most short gynaecological procedures.
Medications for conscious sedation are given through a vein in the arm or back of the hand. You will be awake during your treatment and able to talk to your nurse and doctor, but you will feel drowsy and may continue to do so for several hours afterwards. You may have no or limited memory of the procedure after receiving conscious sedation.
Pain and anxiety are reduced compared to local anaesthetic alone and you don't need to fast or have a long recovery as with general anaesthetic. During the procedure the doctor or nurse can speak with you and you can respond.
What happens during sedation?
Your observations are measured and a cannula (small tube) is inserted into your hand or arm. We encourage you to relax and your surgeon gives you the sedation through the cannula. The effects of the medication can be felt immediately.
Local anaesthetic is given to numb the cervix. Most women are not bothered by this injection once they have received sedating medicines, but you may feel some stinging which does not last long.
The surgeon performs the treatment while a nurse monitors you closely throughout.
After treatment, you will be supported by a member of staff as you walk to the recovery area. Specially trained staff look after you and monitor your recovery. When they are happy that you have recovered from your sedation you will be discharged.
Eating and drinking before conscious sedation:
We encourage you to have a light meal and drink as normal. Please do not eat fried or fatty food.
What about alcohol?
Avoid alcohol for 24 hours before treatment as it can sometimes react with the sedation medication and cause problems.
Please ensure you have a responsible adult to accompany you home and stay with you until the next day. If you don't have someone with you to take you home, you may have your procedure with local anaesthesia and pain medicines by mouth.
You will need to arrange for transportation home as you will be unable to drive, or operate machinery.
Making important decisions or signing documents
Delay signing any documentation or making any serious decisions in the 24 hours following sedation.
What about drugs and medication?
If you are taking medication, please tell us what you are taking and the last time you took it. If you have asthma you will need to bring your inhalers with you. If you are taking recreational drugs, please be open and honest with us as they can affect your sedation. Anything you tell us will be treated in confidence.
Breastfeeding and conscious sedation
Following conscious sedation midazolam and fentanyl are present in breastmilk in low amounts. You can resume breastfeeding as soon as you feel recovered and ready to. Watch for signs of excessive sleepiness in your infant. Before your procedure you may wish to pump and have a supply of breastmilk available for after treatment. It takes 24
hours for the drugs to leave your system completely.
Side effects and complications of conscious sedation
Significant unavoidable or frequently occurring risks:
- Depressed respiration (slowing or stopped breathing) for which you may need oxygen, help with breathing, or medications to reverse the sedation
- Depressed heart rate (pulse) or blood pressure for which you may be given IV fluids
- Nausea and vomiting
- Brief period of amnesia (not remembering what happened)
- Allergic reaction to any of the drugs administered
- Discomfort or bruising at the injection site
- Vein irritation (phlebitis) which can last a week and cause discomfort
- Muscular rigidity (if medicines are given too quickly)