What is conscious sedation?
Conscious sedation is when a patient is given a sedative and a strong pain killer to allow them to have a procedure done with very little or, more often, no pain at all. The sedation is given directly into a vein. It starts working almost immediately and wears off very quickly once the procedure is over. During the procedure, the patient is awake and can speak to the anaesthetic doctor who is looking after them so that they can tell the doctor if they feel any discomfort.
When is it used?
Conscious sedation can be used when procedures are too uncomfortable to have done under a local anaesthetic alone (a local anaesthetic is when an injection is given; in gynaecology, this is normally into the cervix). Conscious sedation is an alternative to a general anaesthetic when patients are completely unconscious and usually have a breathing tube inserted into the throat to help them breath.
The advantages of conscious sedation over a general anaesthetic are:
- Patients can be treated in the outpatient clinic rather than admitted to a ward
- Patients are usually discharged within one to two hours of the procedure so that a hospital visit is normally three to four hours at most
- Patients undergoing sedation seem to have less nausea (sickness).
Conscious sedation is suited to most of the short procedures done in gynaecology.
Do I need to do anything to prepare for a conscious sedation procedure?
Some women may not be suitable for a sedation procedure. Please let the medical and nursing staff know of any medical conditions when you book your treatment.
Because of the small risk of vomiting whilst under sedation, you should not have any food in the six hours before the planned start time of the procedure. You are able to drink clear fluids (water, squash or milk-less tea or coffee) until two hours before the procedure.
You can take your usual medications with a sip of water.
We would advise you to take a pain killer one hour before you attend as this helps your recovery. Any suitable painkillers can be taken such as paracetamol alone, co-codamol, ibuprofen or check with you GP or pharmacist if you are unsure. You must inform the nurse when you attend the clinic what you have taken and when.
What to expect after a conscious sedation procedure?
You should recover from the sedation very quickly and will probably be able to go home after a short rest, often within one to two hours. Occasionally a longer recovery is needed, and patients may be transferred to a ward for this.
Sometimes, women find that they have some pain after the procedure. This happens after a general anaesthetic as well as after a sedation procedure. The nurse looking after you can give you more painkillers to make sure that you are comfortable. The nurse will also complete some checks before you go home.
When will I get the results?
Before you leave the hospital, the doctor / nurse will explain the findings of the procedure or will make a further appointment to do this. If a biopsy has been taken, it may be three to four weeks before the results are available.
Can I drive after conscious sedation?
You should not drive home. When discharged, it is important that a responsible adult accompanies you. We advise you to go home by car or taxi. As with all surgical procedures, you should have a responsible adult stay with you overnight.
What to expect at home?
Once home, simple pain relief may be taken if needed. The nurse will discuss this with you. Please speak to your GP or pharmacist if you are unsure.
Some women feel ready to resume normal activities and work the day after the procedure, others may need to take longer but rarely more than one to two weeks.
After vaginal procedures, light bleeding or spotting for a few days is normal. Some women find that the first period following the procedure is heavier or more prolonged than usual. To help avoid the risk of infection, avoid tampons for at least one week after the procedure. Sexual intercourse should be avoided until bleeding stops.
When to seek help
Most women experience no medical problems following conscious sedation / minor gynaecological procedures.
The hospital or a GP should be contacted immediately if you have any concerns. The following symptoms may indicate an infection or a complication:
- Persistent heavy bleeding
- Pain that lasts for more than 48 hours
- Swollen abdomen or general abdominal pain
- High temperature or fever.
Your GP will be able to help in most cases. If, however, you cannot reach your GP, staff at the Women’s Health Unit or our gynaecology ward may be able to offer advice over the telephone.
Research
At the RVI, we have a large research team and often work with Newcastle University. All of our consultant team are actively involved in research and may discuss the possibility of you getting involved in research at any of our clinics.
Whilst we are very grateful for those who choose to participate, this is not essential and please feel free to decline. This will not affect your care.
What if I cannot attend my appointment?
If you are unable to attend your appointment, please let us know.
Call our secretarial team on 0191 282 5031 (Monday to Friday 8:30 to 5pm).
For further information Contact details
PALS (Patient Advice and Liaison Service) for help, advice and information about NHS services. You can contact them on freephone 0800 032 02 02, email [email protected].
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS website at www.nhs.uk
If you would like to find accessibility information for our hospitals, please visit www.accessable.co.uk
