The agents used for CS often have a relatively narrow therapeutic index. They should therefore be given in small incremental intravenous doses, allowing adequate time for the development and assessment of peak effect. If the desired effect seems unusually difficult or easy to achieve, no additional medication should be administered and the patient should be carefully monitored until the cause is determined ( Table..33.:2). Monitoring of patients and medication administration should be performed by a second provider who understands the pharmacology of the agents used, possesses sound advanced airway-management skills, and will not be distracted by other tasks during the period when the patients' ability to independently maintain their airway is in doubt.
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