You should review the ASA guidelines for procedural sedation. Whether the intended consequence is sedation for a procedure, or anxiolysis+analgesia for an acutely agitated patient, the end result is the same. You will have a patient who may become deeply sedated, lose protective airway reflexes, and require ALS-level care. The reason for the more stringent ASA definitions or what consitutes "procedural sedation" is that the level of sedation required to perform painful procedures on most people is quite deep, and may approach a plane of general anesthesia. Too many EM docs approach this with a very cavalier attitude. This is in no way a question of semantics. If you are using a benzodiazepine and a narcotic in efficacious dosages, you are procedurally sedating, and your patient deserves 1:1 nursing, CR and pulse ox monitors, and the immediate availability of advanced airway mgmt supplies/personnel.