Procedural Sedation and Analgesia

Procedural sedation and analgesia refers to the administration of sedatives combined with an analgesic to help the patient tolerate unpleasant or painful procedures and to decrease the patient’s perception of pain.1 Procedural sedation also increases safety and procedure success while decreasing procedure time.1 Through this technique, the patient will experience a depressed level of consciousness while maintaining independent and continuous airway control.2,3 Our innovative, patented formulation Melt-300 has the potential to replace IV sedation in millions of short-duration medical procedures.

Ideal Characteristics of a Medication for Procedural Sedation

The ideal agent possesses analgesic and amnestic properties, has rapid onset and short duration of action, is safe, and allows rapid recovery and discharge.7

Ramsay Scale of Sedation

The Ramsay scale4,6 is an evaluation method to determine the degree of sedation in the patient.1,4

For procedural sedation and analgesia in cataract surgery, the goal is a Ramsay score of 2-3.

1 Patient awake, anxious, agitated, or restless
2 Patient awake, cooperative, orientated, and tranquil
3 Patient drowsy, with response to commands
4 Patient asleep, brisk response to glabella tap or loud auditory stimulus
5 Patient asleep, sluggish response to stimulus
6 Patient has no response to firm nail-bed pressure or other noxious stimuli


  1. Benzoni T, Cascella M. Procedural Sedation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2019. Accessed January 8, 2020.
  2. Members of the Clinical Policies Subcommittee on Procedural Sedation and Analgesia included:, Jagoda AS, Campbell M, et al. Clinical Policy for Procedural Sedation and Analgesia in the Emergency Department. Ann Emerg Med. 1998;31(5):663-677. doi:10.1016/S0196-0644(98)70216-1
  3. Stone CK. Procedural Sedation and Analgesia. In: Stone CK, Humphries RL, eds. CURRENT Diagnosis & Treatment: Emergency Medicine. 8th ed. New York, NY: McGraw-Hill Education; 2017. Accessed January 5, 2020.
  4. Sessler CN, Jo Grap M, Ramsay MA. Evaluating and monitoring analgesia and sedation in the intensive care unit. Crit Care. 2008;12(Suppl 3):S2. doi:10.1186/cc6148
  5. Park J, Kwon J-Y. Remifentanil or dexmedetomidine for monitored anesthesia care during cataract surgery under topical anesthesia. Korean J Anesthesiol. 2012;63(1):92-93. doi:10.4097/kjae.2012.63.1.92
  6. Rasheed AM, Amirah MF, Abdallah M, P J P, Issa M, Alharthy A. Ramsay Sedation Scale and Richmond Agitation Sedation Scale: A Cross-sectional Study. Dimens Crit Care Nurs. 2019;38(2):90-95. doi:10.1097/DCC.0000000000000346
  7. Sedation in the Acute Care Setting. January 1, 2005, Volume 71, Number 1