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Sedation and general anesthesia are two ways to make a medical procedure comfortable and pain-free for a patient. Both are used when a patient needs an invasive procedure, but each works differently on the body.
Sedation and general anesthesia involve the use of medications to induce a sleep-like state. Sedation is commonly used for minor medical interventions or diagnostic tests. In contrast, general anesthesia is reserved for major procedures like surgery.
As with any medical intervention, there are risks involved in sedation and general anesthesia — but both are safe when performed by experts. In this article, you will learn about the differences between types of sedation and general anesthesia.
What Is Sedation?
Sedation is a form of anesthesia that is characterized by a state of reduced consciousness, allowing a patient to be drowsy but able to tolerate the pain during the procedure. Sedation is often administered by a doctor or nurse anesthetist who has special training in this type of treatment.
Sedation is used for minor medical interventions: dental procedures, examinations like endoscopies or colonoscopies, biopsies, radiation therapy, etc. It can be given orally, intravenously, or through a face mask.
The medications used for sedation can include benzodiazepines (like midazolam), opiates for pain (like fentanyl), and sedative-hypnotics (like ketamine, propofol, and etomidate).
When a dose of pain medication is balanced with a benzodiazepine or sedative-hypnotic, a level of comfort can be achieved for the procedure.
3 Levels of Sedation
While sedation levels really fall on a spectrum, typically sedation is categorized into three levels: minimal, moderate (or “conscious” sedation), and deep sedation. Each level has a specific purpose and basic features.
Minimal Sedation
This level involves a small dose of medication that is enough to leave the patient awake but feeling relaxed during the procedure.
Minimal sedation is often achieved through inhaling nitrous oxide or taking oral medications before the procedure begins. It’s the least intense level of the three. The patient may experience drowsiness but can easily respond to tactile or verbal stimulation. This type of sedation is most commonly used for minor dental treatments.
Moderate or “Conscious” Sedation
Moderate sedation induces a state where a patient can be comfortable during a moderately painful procedure but easily maintain adequate respiratory and cardiac function. Such patients should be under the supervision of personnel who have undergone special training for the administration of sedation and monitoring of the patient. Non-anesthesia clinicians often administer moderate sedation, depending on their state, local, and hospital regulations, and they should have specialized training on how to administer moderate sedation safely.
This level of sedation is recommended for procedures that involve painful or unpleasant medical interventions. Moderate sedation can be administered orally or intravenously. If the medication is going to be administered intravenously, a certified professional will put a catheter into one of the patient’s veins so that drugs could be injected through it.
A patient can have some memory of the procedure when it’s done, but it’s also common for the person to fall asleep and have no recollection of it.
Deep Sedation
Deep sedation is a level of sedation that puts a patient in a drug-induced state. In deep sedation, a patient can be aroused by painful stimuli. Deep sedation may be used for procedures like oral surgery, fracture repairs, and other painful procedures that can be completed without general anesthesia. Breathing and cardiovascular functions are generally not affected by this level of sedation but require close monitoring.
What Is General Anesthesia?
General anesthesia is also a special case that lies on the sedation continuum. It’s an unconscious state that causes a patient to lose awareness and reduces the patient’s ability to experience pain. It is induced by drugs, which are typically administered as an inhaled agent or intravenously. The drugs used in general anesthesia cause loss of consciousness.
While under general anesthesia, the patient will be unable to breathe on their own; therefore, the doctor will take over control of their breathing by placing an endotracheal tube into the patient’s trachea through which oxygen can be given.
When Is General Anesthesia Used?
General anesthesia is often used for more serious, invasive, and longer surgical procedures. For example, if the patient is having a knee replacement, and it’s expected to last three hours, the doctor may recommend general anesthesia. Patients who undergo general anesthesia are monitored closely by doctors throughout their procedure so that they can respond quickly if something goes wrong.
Before any surgery with general anesthesia begins, patients typically go through several steps beforehand:
- preoperative evaluation by an anesthesiologist;
- assessment by other members of the medical team;
- physical exam by a surgeon or nurse practitioner;
- blood tests.
Tests may include checking kidney and liver function levels, as well as finding out whether someone has any allergies or drug sensitivities.
General anesthesia has risks associated with it, but they’re manageable if the patient takes the proper precautions before the procedure. A patient will often have a consultation with a doctor who specializes in anesthesia before their surgery — so that it can be determined whether general anesthesia is right for them.
Conclusion
Sedation and general anesthesia are effective ways to reduce or eliminate pain and anxiety during surgeries of any complexity. Even though each of these methods has its side effects, they continue to be widely used in modern medicine.
The main difference is that sedation makes the patient relaxed so that they don’t feel any pain during the procedure but can be responsive when assessed. Anesthesia causes a sleep-like state so deep that monitoring by a trained anesthesiologist is required. Three levels of sedation and general anesthesia are good options for pain control during procedures. Which level is right for the procedure or the patient’s health status will be determined by the sedation experts.
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