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Chapter 20. Contemporary Patient Sedation and Anesthesia in the Cardiovascular Catheterization Laboratory

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What sedation plane is described by responsiveness to verbal command accompanied by tactile stimulation, unaffected respirations, and cardiovascular stimulation?

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A. Minimal sedation/anxiolysis

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B. Moderate sedation

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C. Deep sedation

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D. General anesthesia

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E. Awake state

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The correct answer is B

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Minimal sedation (anxiolysis) is a drug-induced state during which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected. Moderate sedation/analgesia (conscious sedation) is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained. Deep sedation/analgesia is a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained. General anesthesia is a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive-pressure ventilation may be required due to depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.

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During a preoperative examination, a patient’s mouth was examined, and only a small part of the uvula and soft palate were visible. Which Mallampati score should be assigned?

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A. I

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B. II

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C. III

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D. IV

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The correct answer is C

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Mallampati score is one of the tools that allow screening for potentially challenging airways.

  • Class I: Soft palate, uvula, fauces, pillars visible

  • Class II: Soft palate, uvula, fauces visible

  • Class III: Soft palate, base of uvula visible

  • Class IV: Only hard palate visible

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Which benzodiazepine has the shortest half-life and is the most practical in the setting of short procedural sedation?

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A. Midazolam

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B. Diazepam

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C. Lorazepam

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D. Flumazenil

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The correct answer is A

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The elimination half-life ...

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