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The Canadian Anesthesiologists’ Society (CAS) promotes safe anesthesia care to the highest possible standard. Traditionally, this care was provided in operating rooms by anesthesiologists. Contemporary practice, however, includes many other care locations and providers. Nevertheless, requirements for assessing the patient and managing the medical intervention are independent of provider or location. Procedural sedation is defined as the technique of safely administering short-acting sedative or dissociative agents, with or without analgesics, to reduce discomfort, apprehension, and potentially unpleasant memories while minimizing cardiorespiratory depression of patients during diagnostic and therapeutic procedures. These effects are distinct from both general anesthesia, which provides a state of total unconsciousness, and analgesia alone, which delivers a reduction in or insensibility to pain, not necessarily with a reduction in or a loss of consciousness. Some use of analgesic medication is common for procedural sedation. The larger doses necessary for very painful procedures may be hazardous, however, and other options may need to be considered, such as general anesthesia. Recognizing that adverse events are not uncommon with procedural sedation, the sedation provider must practice careful patient selection and complete a thorough preprocedural assessment. These providers must also be vigilant and prepared to deal with potential complications, such as respiratory depression, airway obstruction, and hypoxemia. Importantly, outside the This article is accompanied by an editorial. Please see Can J Anesth 2018; 65: this issue.

Sédation procédurale : exposé de principe de la Société canadienne des anesthésiologistes