Increase in Sedation Raising Eyebrows

Columbus Dispatch

9/25/06

Sedation is the space between "ouch, that hurts" and "count backward from 100," when the patient doesn’t want to tough it out but doesn’t need to be knocked out. The practice is on the rise, mirroring an increase in the number of outpatient procedures performed in doctors offices, surgical centers and hospitals. Increasingly, doctors who don’t specialize in pain relief are administering those drugs, prompting greater scrutiny and debate over whether some sedation should be left to anesthesiologists. Recently, the University HealthSystem Consortium, an alliance of academic medical centers, urged its members to require training and credentialing for nonanesthesiologists who use sedatives. Most hospitals do, including those in the Columbus area. Dr. Jim Allen, a pulmonologist and internal medicine professor at Ohio State University, was co-chairman of the committee that came up with the consortium’s guidelines for moderate sedation last year. The committee just completed similar guidelines for deep sedation. Doctors need to be prepared to manage patient care if the patient’s level of consciousness slips deeper than the expected level, Allen said.