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Anesthesia | Sedation vs. General Anesthesia

From the Pre-Op Hysterectomy Articles List

Sedation vs. General AnesthesiaWhat is the difference between sedation and general anesthesia?

There are many anesthesia options when having a hysterectomy, some include general anesthesia, while others combine sedation with spinal or epidural anesthesia options.

To understand sedation and general anesthesia, it is important to first define the term sleep. Sleep is the natural state of rest during which your eyes are closed and you become unconscious. Sedation, sometimes referred to as "twilight," is not sleep (though sometimes it looks like sleep), and general anesthesia is deeper than sedation, but not a natural sleep.

There are three levels of sedation:
  • Minimal Sedation: This type of sedation is also called anxiolysis and is created by using a small dose of anti-anxiety medications such as Versed or Valium. You will be awake but less nervous. You’ll be able to respond normally to verbal stimuli and could carry on a conversation, though you may not remember much depending on the dosage and medication used.

  • Moderate Sedation: This type of sedation is usually referred to as "conscious sedation" and is most often achieved with an anti-anxiety drug plus either a narcotic (Demerol or fentanyl for example) or Propofol. During this type of sedation, you will be able to follow commands and respond to verbal/tactile stimulation.

  • Deep Sedation: This state is usually achieved by giving a similar cocktail to conscious sedation but in higher doses. During this type of sedation, you will appear to be asleep but will still be breathing on our own, though you might need a little help with supplemental oxygen, head positioning, oral airway, etc. You will have purposeful movement if something hurts you.

Though the list of sedation options looks clearcut, in reality it's a spectrum, so it's not always easy to tell where you are at any given time, nor do you necessarily stay at a particular level. Minimal and conscious sedation may be fine for procedures that really don't hurt much, or if the surgeon uses adequate local anesthesia to numb the area. In many cases, sedation ends up falling into deep sedation despite the terminology used. It's generally recommended that deep sedation be given only by trained anesthesia providers.

Anesthesia providers go seamlessly back and forth between these levels of sedation depending on the needs of the moment. Your anesthesia provider will monitor you constantly and adjust as needed to keep you safe and comfortable.

Anything deeper than deep sedation is general anesthesia. During this type of anestheisa, you are unarousable even with painful stimulation, and you will need breathing assistance. You are unconscious and not in a natural state of rest. The purposes of general anesthesia are to prevent you from feeling pain during surgery and to keep you from having natural reflexes which could create movement during your surgery.

In the past, general anesthesia was the only option for a hysterectomy, but today modern medicine can allow for a combination of sedation with epidural or spinal anesthesia. You and your doctor can work together to determine what is best for you and your hysterectomy.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

04-14-2014 - 03:45 PM


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