Do u mind chating with me on aim since u work around doctors??? Please.
As a professional anesthesia provider, it is interesting to read all this feedback. Some of the information is slightly correct, but if you don't actually provide anesthesia, then you can not confidently answer the concern. All these replys can be misleading. And no offense surgeons do surgical procedures and do not adminstered anesthesia. Anesthesia providers provide anesthesia and do not perform surgery. Ask the expert on the field of concern.
Conscious sedation and twilight anesthesia are not necessarily interchangeable. Conscious sedation is exactly what it states you are in a state of consciousness. We also used the term monitored anesthesia care which essentially is conscious sedation. With this type of sedation you are aware, we usually use small doses of narcotics and benzodiazepines i.e. Midazolam=versed, and Fentanyl = narcotic. These medications give you antegrade amnesia which means you will not be aware of what is going on, but you will be awake, breathing, you will not realize what is going on. Conscious sedation is used frequently in conjunction with local anesthetics. The local anesthetics numb the area, thus you do not feel pain, but you can feel pressure and pulling. With the use of Versed with local anesthetic you will not be aware of what is going on at the time, but you will not necessarily be sleeping. Risk factors are less, muscle reflexes are not hindered. You have a type of amnesia. One of the safer anesthetics of choice, if able to administer it related to the type of procedure. Very usable for wisdom teeth extraction.
Twilight anesthesia= Intravenous sedation has various different levels. It is by all means in high doses is a general anesthetic. It is administered more, and more frequently during surgeries in conjunction with regional/local anesthesia. The key here for anesthesia is you will be sleeping like you are at home, but you are not "knocked out"! You are maintaining your own breathing patterns. It is deep sedation. But you do not have any protective muscle reflexes. Common medications utilized in this type of anesthesia are Versed, Fentanyl, Propofol. Ketamine is not used frequently related to potential side effects. I deliver anesthesia every day for multiple different surgeries. The trend with technology is to the Intravenous sedation with regional/local blocks. I probably deliver 65% of my anesthetics this way. It is safer than a general anesthetic with endotracheal intubation but it does have some risks, relating to the level of sedation/dosing that they utilize. There is a fine line between breathing and not breathing. It is safe when administered by a trained professional, much more safer if it is administered by an anesthesia provider. Multiple health regulations continue to review this type of anesthesia and are making mandates on who can administer this type of sedation. The trend is that only an anesthesia professional should be delivering this type of anesthesia. Oral surgeons continue to be an exception to this rule at this time, but soon they may not be.
General Anesthesia with endotracheal intubation is the end all be all of anesthesia. It has many risk factors for the healthy and the patient with multiple medical problems. You will not receive this type of anesthesia for oral surgery to remove wisdom teeth. So you do not need to be concerned with this.
You need to decided which level you want, conscious sedation with local anesthetic or IV sedation. More importantly though you need to find out who is administrating the Intravenous medications. As an anesthesia provider, i advocate that you have an anesthesia provider delivering any type of anesthesia. They are highly trained to deal with any type of side effect or airway issues. Oral surgeons do extra rotations in anesthesia when training, but by no means are they airway/anesthesia experts. Many are capable of delivering a type of sedation safely, but they have limitations on the type and amount of medications they can administer. If you are that scared and uncomfortable with having this procedure, i would highly advocate to have an actual "anesthesia provider" give you the level of sedation. Although depending on your oral surgeon you could meet resistance on this.
No type of sedation, anesthesia is without its risks. But the least invasive is always less riskier. Conscious sedation with local is the safest, but that does not mean that local anesthesia with IV sedation is not safe. You just need a provider that is trained to deliver a safe level of deep sedation. Although i can not say that with the appropriate person administering your sedation there wont be any problems, i would though feel comfortable that it is less of a risk with the appropriately trained individual administering these medications. And yes, you are definitely more at risk of dying driving to the surgical center than having sedation administered by a trained anesthesia provider. The risk factor of dying is more that likely less than 0.1%.
And yes, my husband had surgery on a cyst on his back. He had a regional/local/spinal anesthetic with deep IV sedation by an anesthesia provider, and it was 99.5% safe.
I hope this helps.
Certified Registered Nurse Anesthetist.
[EDIT]The views expressed above are not necessarily the views held by this broadcasting station.
It is my wife and she can be a little long winded, but I left it as she wrote it. She also asked me to add, that the healthier you are the less likely you are to have any issue. Your risk rate goes down dramatically. [/EDIT]
"I used to think the brain was the most amazing organ in the entire body. Then I realized who was telling me this."
If ignorance were painful, half the posters here would be on morphine drips.