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Board certified anesthesiologist here, practice with two other board certified anesthesiologists and all three are boarded in pain. As a group we do 800 injections a month or so. We don’t offer sedation. We also have the best online ratings in our market. We also surveyed patients and asked what hurt worse, IV sticks they’ve gotten in the past vs the injection they just had and the IV was more painful or about the same in the overwhelming majority. I truly feel if you find patients needing or wanting sedation for procedures then you need to see what you’re doing in procedures that are different from some of the rest of us that make them hurt or take a hard look at your bedside manner. Also, I would welcome anyone who would like to come see if in action, maybe you can pick up some tricks.
In the old days, an ob who refused to offer labor epidural would have said pretty much the same thing. However, nowaday labor epidural is offered as a standard unless 1) contraindication 2) patient refusal
My question is, do you make an informed consent that patients have the OPTION to get conscious sedation with you if they prefer? For example, they had prior incidence of vasovagal response? Or they just simply tell you she/he is too anxious to do the procedures?
I'm not talking about the procedures that do not need sedation as recommended by ASA position statement. I am talking about the ones ASA says conscious sedation should be AVAILABLE to patients who have significant anxiety or are prone to complications from anxiety, such as vasovagal, can't lay still, etc.
As I said, however you practice in your PP is up to you. However, do you make the effort to inform your patient the option exists?