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), when you are given pain tablets by mouth and local anaesthetic (numbing medicine) is injected into or near your cervix (the entrance to the womb). CS is highly suited to most short gynaecological procedures and is offered during vacuum aspiration at BPAS.
Medications for conscious sedation are given through a vein in the arm or back of the hand. You are awake during treatment and can talk to your nurse and doctor but you will feel drowsy and may continue to do so for several hours after. Many people have no memory of the procedure after receiving CS.
Pain and anxiety are reduced compared to local anaesthetic 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.
Please refer to your copy of ‘My BPAS Guide’ for information about managing pain and other symptoms you may experience at home.
Eating and drinking before conscious sedation:
We encourage you to have a light meal and drink as normal. Don't eat fried or fatty food.
What about alcohol?
Avoid alcohol for 24 hours before treatment as it sometimes reacts with the sedation 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 may also be offered a medical abortion.
You will need to arrange for transportation home as you will be unable to drive, or operate machinery.
Air travel following conscious sedation
Please inform us if you need to fly following your surgery. Flights of 4 hours or more should be avoided for up to 48 hours after recieiving anaesthetic
We advise that:
- If you need to fly after conscious sedation you should only do so, if you flight begins more than 12 hours after receiving your sedative.
- You must be accompanied by a responsible adult who can seek medical help should you become unwell.
- You should only catch your flight if you feel well and are not experiencing any of these symptoms: dizzy, lightheaded, nausea or vomiting, heavy bleeding, severe abdominal pain
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 is treated as confidential.
Breastfeeding and conscious sedation
Following conscious sedation midazolam and fentanyl are present in breastmilk in low amounts, so once you are awake and alert you can breastfeed. It may be useful for you to pump and have a supply of breastmilk available if you do not feel ready to breastfeed for a few hours after your procedure. It takes 24 hours for the drugs to leave your system completely.
Risks and side effects:
- 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)