IV sedation is also known as monitored anesthesia care (MAC), conscious sedation, or twilight sleep.
This article will discuss the types of IV anesthesia, when they are used, and what you should know if you are getting ready to have a procedure that requires you to receive anesthesia.
Levels of Sedation
There are different levels of sedation during monitored anesthesia care. Depending on the surgical procedure, the amount of anesthesia used can range from a minimal amount to enough to produce a deep sleep. You may or may not be able to move around. Patients can often breathe on their own, so intubation (placing a tube into the windpipe) is not needed. Your memory of the procedure may vary depending on the amount of sedation and medications used.
The American Society of Anesthesiologists (ASA) recognizes three basic levels of sedation, which are:
Minimal: Relaxed but awake and able to follow some directionsModerate: Drowsy to sleepy and may not remember some or all of the procedureDeep: Asleep during most of the procedure and likely remember very little
Your provider should explain the planned level of sedation before the start of the procedure.
Benefits
Using IV sedation during plastic surgery and other procedures has many possible benefits, including:
Fast actingRapid recoveryCustomizable doseFewer changes in vital signsFewer side effectsLower risks than general anesthesiaAbility of the patient to cooperateAvoiding use of a breathing tube
Risks
All types of anesthesia carry some level of risk. IV sedation risks can include:
Oversedation Headache Nausea Drowsiness Low drive to breathe Respiratory compromise (needing a breathing tube) Aspiration pneumonia (food or drink gets breathed into the airways or lungs) Increased pain
Before IV Sedation
Before a procedure with IV sedation, you should tell your healthcare provider about allergies or medical conditions you have. You should also inform the provider of any medications you are taking and any prior surgeries you’ve had and the type of anesthesia used.
Typically, you will be evaluated by a healthcare provider trained in anesthesia before the procedure.
You may wish to ask whether an anesthesiologist or a nurse anesthetist will be administering anesthesia. The medical backgrounds and medical training are different for these two types of healthcare professionals.
Follow any instructions provided to you prior to your procedure, including restrictions on food and drink. Avoid drinking alcohol the day before or the day of your procedure as it can affect how anesthesia performs.
It’s important to stop smoking before surgery to reduce the risk of slow healing after the procedure. Following your surgery, you will be given a list of instructions to follow as well as symptoms that should alert you to call your doctor.
After IV Sedation
Typically, you will feel groggy after your procedure and may have a slight headache and nausea. During the recovery process, your nurse will monitor your vital signs, including blood pressure, pulse, and oxygen levels. You usually will be observed for one to two hours after the procedure before you are able to return home with your driver.
Summary
Intravenous sedation (IV sedation) offers a safe alternative to general anesthesia for minor surgical procedures. It can provide sedation ranging from slight (relaxed and mildly sleepy) to deep sleep. Your medical team will help you to understand what kind of anesthesia you will likely need and what to expect.
A Word From Verywell
Certainly, all forms of anesthesia have risks, and it’s important to talk to your surgeon and anesthesiologist about any medical conditions you may have. It is helpful to ask about care after the procedure and to follow the instructions you receive.
Quitting smoking is probably the number one action anyone who smokes can do both to increase the safety of anesthesia and the healing from any surgical procedure.
