Moderate Procedural Sedation and Analgesia

Review previous medical records and interview the patient or family to identify:

• Abnormalities of the major organ systems (e.g., cardiac, renal, pulmonary, neurologic, sleep apnea, metabolic, endocrine)

• Adverse experience with sedation/analgesia, as well as regional and general anesthesia

• History of a difficult airway

• Current medications, potential drug interactions, drug allergies, and nutraceuticals

• History of tobacco, alcohol or substance use or abuse

• Frequent or repeated exposure to sedation/analgesic agents

Conduct a focused physical examination of the patient (e.g., vital signs, auscultation of the heart and lungs, evaluation of the airway, and when appropriate to sedation, other organ systems where major abnormalities have been identified)

Review available laboratory test results

• Order additional laboratory tests guided by a patient’s medical condition, physical examination, and the likelihood that the results will affect the management of moderate sedation/analgesia

• Evaluate results of these tests before sedation is initiated

If possible, perform the preprocedure evaluation well enough in advance (e.g., several days to weeks) to allow for optimal patient preparation

Reevaluate the patient immediately before the procedure.