Driving ability after conscious sedation: a systematic review

Introduction: Conscious sedation is widely used in medicine but may cause impairment of psychomotor and cognitive function that affect some aspects of a patient's life, such as car driving. This systematic review aims to summarize available evidence (direct or indirect) on driving ability after conscious sedation. Evidence acquisition: A comprehensive search was conducted including MEDLINE/PubMed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through June 2022. Randomized and non-randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Evidence synthesis: A narrative synthesis of 27 studies (962 subjects) was conducted, because the heterogeneity in terms of interventions and comparators, method and timing of assessment, and outcome measures precluded the feasibility of a meaningful meta-analysis. Conscious sedation was associated with different degrees of impairment in driving ability (real car driving, simulated driving, subjective perception), and psychomotor and cognitive functions (body sway, sleepiness, adaptive tracking, critical flicker fusion frequency, reaction/attention skills) at 0.5-10 hours after drug administration. Conclusions: The results obtained from this review should be interpreted as a renewed recommendation to avoid driving after conscious sedation is administered. Yet it is not possible to determine when this ability is recovered, leaving this crucial and essential information to future, well-designed and reproducible research.