December 5, 2021

What is sedation? What you need to know

What is sedation or twilight anesthesia? Dr. Kaveh explains what to expect with sedation for your surgery in the operating room.

Patients ask me this question all the time! What IS sedation and how is it different from local anesthesia and general anesthesia? Let's explore twilight sedation and conscious sedation so you know what to expect.

Sedation is a form of anesthesia

Sedation is a "light" form of anesthesia. When you have sedation, your body is not fully unconscious. You are drowsy and are still breathing on your own.

What is anesthesia sedation? Dr. Kaveh explains it's a spectrum between minimal sedation (or twilight) and deep sedation.

Another question is there difference between conscious sedation and twilight sedation. These are all the same type of anesthesia. However, sedation does run on a spectrum of "minimal" to "deep".

Importantly, just because you're not unconscious doesn't mean you will remember anything or feel pain! My patients are very nervous about this! But there's little reason to be afraid. In fact, patients like to have sedation, especially for colonoscopies!

Sedation is a deep, relaxed state that keeps patients breathing spontaneously on their own.
Sedation is a form of anesthesia. You will likely be asleep and comfortable, even though you won’t be unconscious.

The spectrum of sedation

Depending on what your surgery is, and if you have an anesthesiologist or not, your sedation may be mild, moderate, or deep:

  • Mild: you’re relaxed but will be awake enough to follow the directions of your doctor.
    • You may have a nurse provide mild sedation.
    • You’ll be comfortable but may remember some parts of your procedure.
  • Moderate: you’re relaxed and may even fall asleep at points.
    • You will likely have an anesthesiologist.
    • You are less likely to remember large parts of the procedure.
  • Deep: you’ll be deep asleep but not unconscious.
    • You will have an anesthesiologist and should be comfortably breathing on your own. You likely won’t remember the procedure.
Even though you won't be unconscious, you'll be comfortable and probably won't remember your procedure

Will I be awake for my surgery under sedation?

No, you will not be fully awake. But don't expect to be under full anesthesia (including a breathing tube), either!

With high likelihood, you will remember very little from the actual surgery. In fact, you may not remember anything at all. So, even though you'll be in a "twilight zone", you won't be fully asleep, either. This is especially the case if you have moderate or deep sedation with an anesthesiologist.

Will I feel pain if I have sedation?

Not necessarily! Just because you're having sedation (instead of general anesthesia) doesn't mean you're fully awake or aware. You can be very comfortable while under sedation for your surgery.

Many patients are worried about feeling pain under sedation. There are many ways your anesthesiologist can help prevent you from feeling pain, particularly under deep sedation. Because of this, patients want to have deep sedation when possible, particularly in dental procedures.

Do you get a breathing tube when you have sedation?

Unlike general anesthesia, you typically do NOT get a breathing tube when you are having sedation. This is because your body is not fully unconscious. Your body is still able to breathe on its own. That means no breathing tube (and with it, fewer side effects).

But you will get an IV

For the medication to reach your brain (where it acts), you'll need an IV. The small discomfort of the IV is worth the sedation!

What types of surgeries are performed under sedation?

Many types of surgeries are performed under sedation. It depends heavily on your surgeon and anesthesiologists' preferences. Some examples include:

  • Colonoscopies and endoscopies
  • Carpal tunnel release
  • Back injections
  • Minor hand and foot surgeries

References

Baudet, Juan-Salvador, and Armando Aguirre-Jaime. "The sedation increases the acceptance of repeat colonoscopies." European journal of gastroenterology & hepatology 24.7 (2012): 775-780.

Chanpong, Brian, Daniel A. Haas, and David Locker. "Need and demand for sedation or general anesthesia in dentistry: a national survey of the Canadian population." Anesthesia progress 52.1 (2005): 3-11.

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