To the Editor
I was interested that Dr. Shea proposes an eponymous sign for when her patients go ‘poof’ or ‘pouf’ during sedation. (1) It seems that her techniques sometimes result in loss of consciousness, since she ‘sometimes wakes them up” whilst gauging the level of sedation.
Many anesthesiologists would not support this. Sedation is defined as “a mild state of cortical depression in which the patient is calm and tranquil but awake.” (2) This avoids the risks resulting from hypnosis (a drug-induced sleep), such as disinhibition, involuntary movement, coughing, straining, obstruction, etc.
“Conscious sedation is an art not easily learned” (3) and anesthetic immortality is not easily earned.
Incidentally, Webster’s Third International Edition defines ‘Pouf’ as (a) something that is inflated or insubstantial (b) bouffant or fluffy part of a garment or clothing (c) an evanescent whiff (as of smoke). The latter is appropriate, since the Greek word ‘capnos’, ‘smoke’, is the root for capnography, which is of course our useful respiratory monitoring system.
David R. Ball, MBBS
Department of Anesthesiology UCI Medical Center Orange, CA
References
- Shea K. Is the patient adequately sedated? (letter). APSF Newsletter, Spring 1994; 9:12.
- Collins VJ (ed) Principles of Anesthesiology, 3rd ed, Lea and Febiger, (1993), p. 288.
- Shane SM: Conscious Sedation for Ambulatory Surgery. Baltimore University Park Press, (1983), p. 1.