If a patient develops pain during surgery using a local anaesthetic technique the patient requires analgesia and not sedation. The surgeon should supplement the block using local anaesthesia or small doses of intravenous analgesia should be given. If sedation is to be used then small doses of a short acting agent such as midazolam should be given. Diazepam in small doses may also be an option. Propofol in small 10mg increment doses can also be used especially prior to performing a local anaesthetic eye block.
Some anaesthetists use small doses of alfentanil or fentanyl.
The key to good sedation is to maintain verbal contact with the patient. Careful surgical draping is also important. Patients become claustrophobic if their faces are draped. Oxygen should be given to the patient, especially if sedation is to be used. Patients may find a face mask or nasal oxygen cannulae uncomfortable.