Sedation Scoring System of Nisbet and Norris

Preoperative sedation can be assessed by a simple scoring system.

Basis:

(1) by definition it is not possible for a sedated patient to be anxious

(2) a well-sedated patient should be able to withstand a stressful stimulus

Observation	Criteria	Finding	Points
Subjective	subjective state in anesthetic room	apprehensive, anxious	0
		fully awake	1
		drowsy	2
	change in state from ward to anesthetic room	apparent improvement	2
		no change	1
		apparent deterioration	0
Objective	change in blood pressure from ward to anesthetic room	fall in blood pressure > 10 mm Hg	2
		no change in blood pressure	1
		rise in blood pressure > 10 mm Hg	0
	change in heart rate from ward to anesthetic room	fall in heart rate > 10 beats per minute	2
		no change in heart rate	1
		rise in heart rate > 10 beats per minute	0
	blood pressure after stimulation	rise in blood pressure > 10 mm Hg	0
		no change	1
	heart rate after stimulation	rise in heart rate > 10 per minute	0
		no change	1

where:

• the stimulus is to ask the patient to breath into an anesthetic facepiece

score =

= SUM(points assigned)

Interpretation:

• minimum score 0

• maximum score 10

Score	Sedation	Interpretation
7 to 10	good	demonstrable sedation
5 or 6	fair
0 to 4	poor	show evidence of anxiety (tachycardia and/or hypertension and/or nervousness and/or response to stimulus)

To read more or access our algorithms and calculators, please log in or register.