PhD defence Marloes Catharina Homberg

Keywords: Procedural sedation and analgesia, Non-operating room anesthesia, Respiratory complications, High-flow nasal oxygen

"Optimizing procedural sedation and analgesia: from patient selection to post-procedural care"

Procedural sedation and analgesia (PSA) provided by anesthesia care providers is widely used in non-operating room anesthesia (NORA) settings. The primary objective of PSA is to ensure patient comfort by reducing anxiety and pain during diagnostic or therapeutic procedures. Adequate patient tolerance, achieved through anxiolysis, amnesia, and/or analgesia, is essential for the safe and effective completion of these interventions.  

The main aim of this thesis was to evaluate the safety and quality of PSA administered by anesthesia care providers, with particular focus on  complications and clinical outcomes in NORA settings. In addition, opportunities to further optimize PSA and improve patient care were explored. 

The studies included in this thesis focused on two common clinical indications: catheter ablation for atrial fibrillation (AF) and percutaneous thermal liver tumor ablation. Although both procedures are performed under deep sedation, respiratory complications are the primary concern during AF ablation, whereas pain management is the main challenge during liver tumor ablation.

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