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Thursday, December 12, 2013
Deep sedation vs general anesthesia
I am scheduled for gynecological surgery. I have been given the choice of a general anesthesia and a deep sedation. I am not clear about the state of awareness. I appreciate your input and expertise.
Deep sedation and general anesthesia are part of a continuum. In other words, the one shades into the other. The same medicines can be used to produce deep sedation as general anesthesia.
During general anesthesia a patient is unrousable, unconscious, lacking in recall. There is no awareness of events taking place around the person, including the surgical procedure. Some form of airway device is usually inserted because general anesthesia causes the airway muscles to lose their tone - they loosen up - and the airway may then become obstructed unless the anesthesiologist takes action to keep it open.
During deep sedation insertion of an airway is usually, but not always, unnecessary. During deep sedation, there may be some mild depression of breathing whereas during general anesthesia breathing is definitely impaired, hence the need for extra oxygen and, sometimes, mechanical help with breathing. During deep sedation the blood pressure is usually okay, during general anesthesia a drop in blood pressure is a common feature. I hope this answers your question.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University