Twilight anesthesia - wikipedia Twilight anesthesia This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. ( May 2009 ) Play media Patient and doctor describing state of consciousness similar to `` twilight anesthesia '' Twilight anesthesia is an anesthetic technique where a mild dose of general anesthesia is applied to induce anxiolysis ( anxiety relief ), hypnosis, and anterograde amnesia ( inability to form new memories ). The patient is not unconscious, but sedated. During surgery or other medical procedures, the patient is under what is known as a `` twilight state '', where the patient is relaxed and `` sleepy '', able to follow simple directions by the doctor, and is responsive. Generally, twilight anesthesia causes the patient to forget the surgery and the time right after. It is used for a variety of surgical procedures and for various reasons. Just like regular anesthesia, twilight anesthesia is designed to help a patient feel more comfortable and to minimize pain associated with the procedure being performed and to allow the medical practitioner to practice without interruptions. Contents 1 Overview 1.1 Level One 1.2 Level Two 1.3 Level Three 1.4 Level Four 2 Applications 3 Drugs and technology used 4 Effects 5 Uses 6 References Overview Twilight anesthesia is commonly known as twilight sleep and calls for an easy awakening and speedy recovery time by the patient. Anesthesia is used to control pain by using medicines that reversibly block nerve conduction near the site of administration, therefore, generating a loss of sensation at the area administered. Close monitoring by the anesthesiologist will sometimes be provided, to help keep the patient comfortable during a medical procedure, along with other drugs to help relax the body. It can also help control breathing, blood pressure, blood flow, and heart rate and rhythm, when needed. There are four levels of sedation by anesthesia. Level one This level called Minimal sedation causes anxiolysis, a drug induced state in which the patient responds normally to verbal commands. Although the cognition and coordination of the patient are impaired, cardiovascular and ventilatory functions remain unaffected. Level two In this level called Moderate sedation / analgesia or conscious sedation, a drug induced depression of consciousness during which the patient responds purposefully to verbal commands, either alone or accompanied with light physical stimulation. Breathing tubes are not required for this type of anesthesia. This is Twilight Anesthesia. Level three In this level called Deep sedation / analgesia, a drug - induced depression of consciousness during which the patient can not be easily aroused, but responds purposefully following repeated or painful stimulation. Ventilatory functions may be impaired, breathing tubes are required. Cardiovascular functions are usually sustained. Level four In this level called Anesthesia, a combination of general anesthesia and spinal or major regional anesthesia. It does not include local anesthesia. Ventilatory function is often impaired and cardiovascular functions may be impaired. Applications Several factors are taken into consideration when determining which level of anesthesia is used under which type of medical procedures. Along with the factors determined, different types of anesthesia medications are used depending on the medical procedure being done. While the patient is under level two of sedation by anesthesia, depending on the type and dose administered, they are in a state that is known as a `` twilight '' state, thus attaining the name `` twilight anesthesia. '' Drugs and technology used The same drugs used in general anesthesia are also used for twilight anesthesia, except in smaller doses and in a bolus interval ( A concentrated mass of a substance administered intravenously for diagnostic or therapeutic purposes ). These drugs can be administered via gases, such as nitrous oxide ( laughing gas ), or intravenously, with drugs such as ketamine ( pediatrics primarily, and infrequently in adults ), propofol, and midazolam. Twilight anesthesia alone is not used to provide relief from surgical pain, therefore, it is always given in conjunction with a local or regional anesthetic. Additionally, IV sedation is frequently administered as a concoction of several agents including those previously mentioned for induction and maintenance of anesthesia, as well as a benzodiazepine ( usually midazolam, but temazepam or flunitrazepam are also used via the oral route ) and a narcotic / systemic analgesic such as demerol or fentanyl. As discussed in the levels of sedation by anesthesia, assistance with breathing tubes ( ETT or LMA ) are not generally used for this type of anesthesia. Effects A few studies have been geared towards studying the effects of post operative analgesic regimes that measure the quality of recovery period and health - related quality of life. Factors other than degree of analgesia and presence of analgesic agent - related side effects ( e.g., fatigue, physical functioning, and mental health ) may potentially influence these outcomes. Twilight anesthesia offers a limited recovery period after procedures, and is usually associated with less nausea and vomiting than general anesthesia which makes it a popular choice among doctors who are performing procedures such as minor plastic surgeries. Uses Twilight anesthesia is applied to various types of medical procedures and surgeries. It is a popular choice among surgeons and doctors who are performing anything from minor plastic surgeries to dental work, and procedures that do not require extensive operations or long durations in favor of less nausea and a limited recovery period after surgery. Twilight anesthesia is used for surgical uses. Ambulatory Surgical Centers Cosmetic Surgeons Dentists Dermatologists Endodontists ENT Surgeons General Surgeons Gastroenterology Gynecologists MRI Centers Neurologists Neurosurgeons Ophthalmologists Oral Surgeons Orthopedic Surgeons Pediatric Dentists Periodontists Plastic Surgeons Podiatrists / Foot Surgeons Psychiatrists Radiologists Rheumatologists Urologists References Jump up ^ `` Anesthesia - Topic Overview ''. Pain Management Health Center. Healthwise, Incorporated, & WebMD. 2008 - 02 - 04. Retrieved 2009 - 03 - 01. ^ Jump up to : Jcaho, Inc Joint Commission Resources ( 2001 ). Anesthesia and Sedation : Illustrated Edition. Joint Commission Resources. Jump up ^ `` Twilight Anesthesia For Dentistry ''. Arthur Glosman DDS. 2015 - 02 - 02. Retrieved 2015 - 02 - 12. Jump up ^ Bailie R, Christmas L, Price N, Restall J, Simpson P, Wesnes K ( July 1989 ). `` Effects of temazepam premedication on cognitive recovery following alfentanil - propofol anaesthesia ''. Br J Anaesth. 63 ( 1 ) : 68 -- 75. PMID 2569887. doi : 10.1093 / bja / 63.1. 68. Jump up ^ Capdevila, Xavier ; Choquet, O ( October 2008 ). `` Does regional anesthesia improve outcome ? Facts and dreams ''. Techniques in Regional Anesthesia and Pain Management. 12 : 161 -- 2. doi : 10.1053 / j. trap. 2008.09. 001. Anesthesia ( outline ) Types General Sedation Twilight anesthesia Local Topical Intercostal nerve block Neuraxial blockade Spinal Epidural Dental Inferior alveolar nerve Techniques Airway management Anesthesia provision in the US Arterial catheter Bronchoscopy Capnography Dogliotti 's principle Drug - induced amnesia Intraoperative neurophysiological monitoring Nerve block Penthrox inhaler Tracheal intubation Scientific principles Blood -- gas partition coefficient Concentration effect Fink effect Minimum alveolar concentration Second gas effect Measurements ASA physical status classification system Baricity Bispectral index Entropy monitoring Fick principle Goldman index Guedel 's classification Mallampati score Neuromuscular monitoring Thyromental distance Instruments Anaesthetic machine Anesthesia cart Boyle 's machine Gas cylinder Laryngeal mask airway Laryngeal tube Medical monitor Odom 's indicator Relative analgesia machine Vaporiser Double - lumen endotracheal tube Endobronchial blocker Complications Emergence delirium Allergic reactions Anesthesia awareness Local anesthetic toxicity Malignant hyperthermia Perioperative mortality Postanesthetic shivering Postoperative nausea and vomiting Postoperative residual curarization Fields of study Cardiothoracic Geriatric Oral sedation dentistry Professions Anesthesiologist Anesthesiologist assistant Nurse anesthetist Operating Department Practitioners Certified Anesthesia Technician Certified Anesthesia Technologist Anaesthetic technician History A.C.E. mixture Helsinki Declaration for Patient Safety in Anaesthesiology History of general anesthesia History of neuraxial anesthesia History of tracheal intubation Organizations American Association of Nurse Anesthetists American Society of Anesthesia Technologists & Technicians American Society of Anesthesiologists Anaesthesia Trauma and Critical Care Association of Anaesthetists of Great Britain and Ireland Association of Veterinary Anaesthetists Australian and New Zealand College of Anaesthetists Australian Society of Anaesthetists International Anesthesia Research Society Retrieved from `` https://en.wikipedia.org/w/index.php?title=Twilight_anesthesia&oldid=796644918 '' Categories : Anesthesia Hidden categories : Articles needing additional references from May 2009 All articles needing additional references Articles containing video clips Talk Contents About Wikipedia Add links This page was last edited on 22 August 2017, at 07 : 03. 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Question: what do they give you for twilight sleep
Answer: The same drugs used in general anesthesia