What is the ASA physical status classification for risk assessment prior to sedation?

Updated: Nov 06, 2018
  • Author: Arul M Lingappan, MD; Chief Editor: Erik D Schraga, MD  more...
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The American Society of Anesthesiologists (ASA) developed a physical status classification system to risk-stratify patients receiving sedation for surgical procedures.

  • Class 1 - A normal healthy patient

  • Class 2 - A patient with mild disease

  • Class 3 - A patient with severe disease

  • Class 4 - A patient with severe disease that is a constant threat to life

  • Class 5 - A moribund patient who is not expected to survive without the operation

ASA class 3 or higher is proven to be an independent risk factor for adverse outcome in patients undergoing general anesthesia. [31] Procedural sedation in the ED has been studied most extensively in patients who are ASA class 1 and 2. These patients are at low risk for periprocedural and postprocedural complications. [30] Many clinicians would opt not to give sedation to a patient in ASA class 3 or greater, given a risk of morbidity or mortality. Hopefully, this subject will be studied to further streamline periprocedural assessment and the applicability of the ASA physical status classification system to the ED.

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