Sedation was once thought to be the primary choice of anesthesia only for patients in whom general anesthesia was deemed too risky. This is no longer the case with sedation being the first choice in 10-30% of all surgical procedures. In addition to more wide spread acceptance, sedation is now being utilized in more complex procedures in patients with more medical comorbidities. Examples can be found in the advanced endoscopic procedures being performed in the GI Suite, to surgical terminations being performed later into the second trimester, to the advances in the treatment of cardiovascular and vascular patients undergoing minimally invasive procedures.
Sedation is a continuum from mild sedation, where the patient can respond to verbal stimuli, to deep sedation without intubation, where the patient is difficult to arouse and may require repeated tactile or painful stimuli. A major concern during procedural sedation, especially deep sedation, is loss of the airway leading to hypoxia and/or hypercapnia. Closed claims review of nonoperating room anesthesia (NORA) nearly a third of all claims, which were deemed to be preventable, was due to inadequate oxygenation and ventilation. The challenge of safely sedating these patients is likely complicated by the obesity epidemic and the presence of obstructive sleep apnea as well as other comorbidities as the surgical population ages. In this special issue, the many aspects of Anesthesia provided sedation for different surgical procedures will be reviewed.

Aims and Scope:

1. Monitored Anesthesia Care
2. Deep Sedation
3. Airway Compromise
4. Obesity
5. Obstructive Sleep Apnea
6. Nonoperating Room Anesthesia (NORA)