Providing moderate sedation in the clinic setting provides a supportive environment and improved experience for patients. Getty Images.
UC San Diego Health is the first health system in San Diego to receive national certification from the Accreditation Association for Ambulatory Health Care (AAAHC) to offer in-clinic moderate sedation for certain treatment options, such as minimally invasive gynecological, contraceptive and family planning procedures.
In November 2024, UC San Diego Health opened a new obstetrics and gynecology clinic in La Jolla that offers general and highly specialized gynecologic care to address certain conditions, such as endometriosis, fibroids and infertility. The clinic also offers minimally invasive gynecological surgery and complex contraception procedures, including those requiring moderate sedation.
After months of preparation, UC San Diego Health received AAAHC accreditation to offer moderate sedation at the new clinic in May 2025, which stipulates very strict standards focused on patient safety and qualified staffing. The first procedure was performed in June 2025.
Moderate sedation, also known as conscious sedation, involves medications given intravenously and is used to decrease pain and anxiety during gynecological procedures that can be uncomfortable for patients.
The option is offered for the following treatments:
- Minimally invasive gynecological surgery to conduct a biopsy or tissue sampling, including endometrial biopsies, colposcopies, and LEEP procedures for abnormal pap smears
- Hysteroscopies in order to diagnose and treat diseases of the uterus, such as polyps and fibroids
- Insertions of intrauterine devices (IUDs)
- Endometrial ablations for patients who experience heavy bleeding during periods
- Family planning procedures, including dilation and curettages
In this Q&A, UC San Diego Health physicians Shira Varon, MD, obstetrician and gynecologist, and Sheila Mody, MD, complex family planning specialist, discuss how moderate sedation in the clinic setting provides a supportive environment and improved experience for patients.
How does offering moderate sedation in the clinic setting improve patient care?
Mody: Before offering moderate sedation in the clinic, patients would have to wait for operating room availability in the hospital to receive these procedures, which can be a very lengthy process for the patient.
This accreditation now allows us to offer a comprehensive range of pain control options in the clinical setting so that procedures can be done in a timelier, less intrusive, but equally safe environment. As a result, stress, anxiety and discomfort are diminished. This has resulted in more personalized care and an improved experience for our patients.
What does the patient experience during moderate sedation?
Varon: Moderate sedation is different from what is known as deep sedation or general anesthesia because under moderate sedation a patient can still respond to verbal commands and is able to maintain breathing without medical support. While moderately sedated, the patient will feel relaxed and may fall asleep, but can be awoken easily.
In addition to moderate sedation, we also offer other options in-clinic to help relieve pain, including oral sedation medications and/or local anesthetics, and most recently, nitrous oxide, also known as laughing gas.
How does the clinic's design support this new offering?
Varon: The new clinic is located in an existing UC San Diego Health medical office in La Jolla. In early 2024, it was completely remodeled in order to meet the requirements for AAAHC accreditation, and we put a lot of thought into the design of the clinic itself to ensure we were able to offer these procedures in a comforting and private environment. This includes calming artwork, as well as larger clinical rooms and waiting areas.
Mody: The space itself consists of four exam rooms, four procedural rooms and an ultrasound suite. It also offers expanded access to our complex family planning specialists, all who work in the clinic and focus on compassionate person-centered care for procedures, such as deep contraceptive implant removals, pain control for intrauterine device insertion and complex intrauterine device removals.
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