When should conscious sedation be used or considered when planning a musculoskeletal intervention?
Conscious sedation refers to the administration of medications, resulting in minimally depressed consciousness such that a patient is able to maintain an airway and respond to commands. This is normally accomplished by the intravenous administration of an analgesic (e.g., fentanyl) and an anxiolytic (e.g., midazolam). Musculoskeletal interventions that require conscious sedation include any type of bone biopsy. Conscious sedation is also recommended for biopsies of the feet, the hands, suspected peripheral nerve sheath tumors, and the soft tissue component of a bone tumor, because they can be extremely painful. Finally, conscious sedation may be considered for any soft tissue biopsy or for any patient who is extremely anxious or intellectually disabled.