[Sedation in surgical procedures using regional anesthesia in adult patients: results of a survey of Spanish anesthesiologists].
OBJECTIVE
To analyze the frequency and methods of sedation used in the context of regional anesthesia in adults by means of a national survey.


METHODS
We carried out a survey of participants at the courses of an anesthesiology training organization (Fundación Europea de Enseñanza en Anestesiología), held in Spain in 2006. The survey questionnaires asked about indications for sedation used during surgery under regional anesthesia as well as the form of administration, follow-up, and complications.


RESULTS
A total of 375 questionnaires were sent out and 185 responses were received (49.3%). Sedation is always used to accompany regional anesthesia by 69.2% of the respondents; 13.5% of them discuss the technique to be used with the patient and come to an agreement. The same type of sedation, regardless of the regional block performed, is used by 49.2% of respondents, and 64.3% use a scale to evaluate the level of sedation. The most favored sedation technique is continuous infusion, followed by target controlled infusion and boluses on demand. The most commonly used technique is sedation with bolus injections. Sixty percent use a single agent and 38.9% use combinations. The most commonly reported adverse effects are variability of patient response (53.5%) and respiratory complications (27%). In cases of ineffective regional blockade, 49.2% of those surveyed switch to general anesthesia.


CONCLUSIONS
Sedation is very often used to complement regional anesthesia in adult patients. Even though continuous infusion is considered to be the most appropriate form of administration, the most commonly used form is injection of boluses. Sedation with a single drug is used more frequently than drug combinations. Variability of individual response is the complication most commonly reported by the respondents.
Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario Juan Canalejo, A Coruña. prmaceiras@wanadoo.es
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Rama-Maceiras
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Gomar
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Criado
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Arízaga
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A
Rodríguez
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Marenco
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000328:Adult; D000765:Anesthesia, Conduction; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013030:Spain; D011795:Surveys and Questionnaires
D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D008874:Midazolam