Procedural Sedation and Analgesia (PSA), an alternative to general anaesthesia for surgical procedures outside the hospital environment

Abstract

We are in the midst of a dynamic time for sedation practice as this is probably the fastest growing area in anaesthesia care. According to all sedation guidelines, including the 2015 SASA guidelines on PSA, we can administer PSA outside the hospital in a medical or dental surgery, in the office, a facility, or in sedation clinics. This versatility makes PSA an attractive option for us. PSA outside the hospital environment involves a multitude of providers, and non-anaesthesiologists will be and are part of this group. The choice of which provider delivers this care and the techniques and drugs used, is usually specific to each institution/country and is largely dependent on the availability of trained providers. In developing countries we face different challenges. There are not enough anaesthesiologists and other healthcare providers available to provide anaesthesia services for all in-hospital procedures. PSA then becomes a very attractive option for certain surgical interventions as it can be used outside the hospital.