Meet The Team

Procedural Sedation

This page explains what procedural sedation is, how it works and when you may need it. It explains the benefits and risks of using sedation and what it might feel like. Included is information you will need to prepare for your procedure under sedation and important points to consider for your care after sedation.

What Is Sedation?

Sedation is when drugs are given to help you feel more relaxed and less aware during a procedure. The drugs (sedatives) are usually given into your vein (intravenous or IV) but can sometimes be given by mouth (oral) or through a face mask.

Three Levels of Sedation

There are three different levels of intravenous sedation. They are called ‘minimal’, ‘moderate’ (sometimes also called conscious sedation) and ‘deep’ sedation.



Minimal Sedation (Anxiolysis)

You feel relaxed and less worried. You can fully communicate with the health professionals and will usually remember most of the procedure.



Moderate Sedation

You feel very relaxed and sleepy but can talk and follow instructions. You may drift off to sleep at times but will be easy to wake.



Deep Sedation

You are likely to sleep through most of the procedure and may not remember it.

The main differences between sedation and general anaesthesia are your level of consciousness, the need for specialised equipment to help support your breathing and possible side effects.

The depth of sedation is determined by what is safe considering your general medical condition and by what is required for your comfort during surgery.

Sedationists are trained to administer the right amount of sedative and manage any potential side effects. Your sedationist will stay with you during your treatment to adjust the level of sedation continuously and monitor your breathing and oxygen levels.

Common Questions about Sedation

Who will administer my sedation?

“Sedationist” is the name given to the healthcare professional who administers your sedation. In the operating theatre, that person is usually a specialist anaesthesiologist. In other places in the hospital or clinics outside of the hospital, this may be a doctor or other trained healthcare professional. The South African Society of Anaesthetists has published clear guidelines on the minimum qualifications of the person administering your sedation. These guidelines also contain safety standards for the rooms/clinic or hospital where the procedure will take place, equipment that must be available, drugs to be used etc.

What are the benefits of sedation?

Procedural sedation offers several benefits, including:

Reduced Anxiety and Fear: Many patients feel anxious or fearful about medical procedures. Sedation helps to alleviate these feelings, making the experience more comfortable.
Pain Relief: Sedation can help manage pain during procedures, ensuring that you feel minimal discomfort.
Enhanced Cooperation: Patients who are relaxed and comfortable are more likely to cooperate during the procedure, making it easier for healthcare providers to perform the necessary tasks.
Amnesia: For some patients, it’s beneficial not to remember the procedure. Sedation can induce temporary memory loss, so you won’t recall the details of the procedure.
Improved Safety: By reducing anxiety and pain, sedation can help lower the risk of complications related to stress and movement during procedures.
Faster Recovery: Sedation can lead to a quicker recovery time compared to general anesthesia, as it typically involves fewer side effects and a shorter duration of drowsiness.
Increased Convenience: For certain procedures, sedation allows you to avoid the need for more invasive anesthesia options, making the process less complex and more convenient.

Overall, procedural sedation helps to create a more comfortable and less stressful experience, while also ensuring safety and efficiency. If you have any specific concerns or questions, it’s always a good idea to discuss them with your healthcare provider.

What treatments can be carried out under intravenous sedation?

Many minor treatments and investigations can be undertaken with intravenous sedation, often together with a local anaesthetic.

A few examples include:

skin or breast biopsies
minor repair to fractured bones
minor surgery to the skin, hand or foot
procedures to help diagnose problems with the stomach (endoscopy), the lung (bronchoscopy), the colon (colonoscopy), or the bladder (cystoscopy)
removal of teeth or other dental treatment
eye operations, such as cataract removal.
cosmetic surgery

Certain more extensive treatments can also be carried out under sedation and local anaesthesia.

Risks and side effects

In modern sedation, serious problems are uncommon. Risk cannot be removed completely, but modern drugs, equipment and training have made sedation much safer in recent years. Sedationists take a lot of care to avoid all the risks outlined. They will be able to give you more information about any of these risks and what they do to avoid them.

Common Side Effects

Nausea and Vomiting: These are quite common and usually occur shortly after the procedure. They can be managed with anti-nausea medications.
Drowsiness or Sleepiness: Patients often feel very sleepy and may need to rest for a while after the procedure.
Headache: This can happen due to the sedative medications used.
Dizziness: Feeling unsteady or lightheaded is common and usually resolves quickly.
Short-term Memory Loss: Some patients may not remember the procedure or the time immediately after it.
Feeling Unsteady on Your Feet: This can occur due to the sedative effects and usually resolves with time.

Less common and rare complications

Respiratory Depression: This is a condition where breathing becomes slow or shallow. It requires immediate medical attention and can be managed with assisted ventilation.
Hypoxia: Low oxygen levels in the blood can occur, especially if there is respiratory depression. Monitoring oxygen levels and providing supplemental oxygen can help manage this.
Hypotension: A drop in blood pressure can happen, especially with certain sedatives. It is usually transient and can be managed with fluids or medications.
Bradycardia: A slow heart rate can occur, which may need medical intervention if it becomes severe.
Laryngospasm: This is a spasm of the vocal cords that can cause difficulty breathing. It is rare but can be managed with medications and airway management techniques.
Aspiration: Inhaling stomach contents into the lungs can happen, especially if vomiting occurs during sedation. It requires immediate medical attention.

Need for Intubation: In rare cases, a tube may need to be inserted into the airway to help with breathing
Allergic reaction: This might vary from mild, such as itching and a rash to more severe.

This is not an extensive list of all possible side effects. Your medical status and the procedure planned will determine your individual risk of side effects and complications. Your sedationist will take a careful medical and surgical history from you before the procedure, as well as do a physical examination. This will help them to determine risk and to plan the safest mode of anaesthesia for you. This is a good opportunity to discuss any specific concerns you might have regarding any of the above-stated side effects and complications before you sign consent for the procedure.

What can I do to prepare for a procedure with sedation?

Unless specifically advised, please do not eat for 6 hours before your procedure.

You are allowed clear fluids such as clear apple juice, Energade and coffee or tea without milk or milk alternatives up to 4 hours before your procedure.
You can take sips of water up to 2 hours before your procedure.
If you are diabetic or using Succenda/Ozempic, please alert your doctor on booking. Alternative fasting guidelines might be applicable.
Please alert the medical personnel if you have any drug allergies

If you have people that you look after, for example, children or older people, you will need to plan for someone else to look after them until the day after the procedure.
A capable adult will need to take you home by car or taxi ideally – using public transport is not advised after sedation. As the effects of sedation can last up to 24 hours, they should stay overnight to look after you.
Take all your medicines to the hospital with you, including any inhalers and any over-the-counter medicines you take regularly. Unless specifically instructed, please take all your regular medications as usual.
If you have an illness or a cold, or you are pregnant, please contact your hospital or clinic, as it may not be safe to have sedation. Your treatment may have to be rearranged. Let your doctor know on the day of the procedure if you are breastfeeding.
Bring some loose clothing, such as a dressing gown or a fleece, to keep you comfortable and warm.
Wear flat shoes that are easy to put on.

What happens after the procedure?

If you have light or moderate sedation, you can usually go home within an hour or two of your treatment. If you have deep sedation, your recovery might take longer. When you can go home may also depend on how long it will take you to recover from the procedure itself.

Pain medication will be prescribed or provided as needed and depending on the procedure involved.

A capable adult will need to take you home by car or taxi – ideally not public transport – and remain with you overnight. If you have not organised for someone to be with you after treatment, you may need to stay in hospital overnight, or your treatment may need to be postponed.

Sedation may make you unsteady on your feet. Please be careful on stairs and have somebody with you if you feel unsteady.

Your ability to make decisions and judgements may be affected for up to 24 hours after your treatment, so you should not make any important decisions during that time. You should avoid posting on social media/public forums too.

You should not return to work, look after dependants, drive, cook or operate any machinery for 24 hours as it may take this length of time for the drugs to leave your body.

You should not take any alcohol or sleeping tablets for 24 hours after the procedure.

It is advisable to discuss with your doctor what you should do if you feel unwell or have any concerns after you have left. Make sure you have the relevant contact numbers easily at hand. If you are not able to contact the medical professionals involved, please go to your nearest emergency unit.