• Maartje van Haperen, Benedikt Preckel, and Susanne Eberl.
• Department of Anesthesiology, Amsterdam University Medical Centers UMC, Location AMC, Amsterdam, The Netherlands.
• Curr Opin Anaesthesiol. 2019 Dec 1; 32 (6): 769-775.

Purpose Of ReviewThere is a steadily increasing demand for procedural sedation outside the operating room, frequently performed in comorbid high-risk adult patients. This review evaluates the feasibility and advantages of sedation vs. general anesthesia for some of these new procedures.Recent FindingsGenerally, sedation performed by experienced staff is safe. Although for some endoscopic or transcatheter interventions sedation is feasible, results of the intervention might be improved when performed under general anesthesia. For elected procedures like intra-arterial treatment after acute ischemic stroke, avoiding general anesthesia and sedation at all might be the optimal treatment.SummaryAnesthesiologists are facing continuously new indications for procedural sedation in sometimes sophisticated diagnostic or therapeutic procedures. Timely availability of anesthesia staff will mainly influence who is performing sedation, anesthesia or nonanesthesia personal. While the number of absolute contraindications for sedation decreased to almost zero, relative contraindications are becoming more relevant and should be tailored to the individual procedure and patient.

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