Intravenous (IV) Sedation Uses and Benefits

Intravenous (IV) sedation is a type of anesthesia given through a tube placed in a vein. It helps you relax, prevents you from feeling pain, and is mainly used for minor medical procedures that don't require deeper general anesthesia.

IV sedation is also known as monitored anesthesia care (MAC), conscious sedation, or twilight sleep.

This article discusses 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 anesthesia.

What Are the Levels of IV 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 directions
• Moderate: Drowsy to sleepy and may not remember some or all of the procedure
• Deep: Asleep during most of the procedure and likely to remember very little

Your provider should explain the planned level of sedation before the start of the procedure.

Benefits of IV Sedation

Using IV sedation during plastic surgery and other procedures has many possible benefits, including:

• Fast acting
• Rapid recovery
• Customizable dose
• Fewer changes in vital signs
• Fewer side effects
• Lower risks than general anesthesia
• Ability of the patient to cooperate
• Avoiding use of a breathing tube

Risks of IV Sedation

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.

During IV Sedation

There is no single drug used during IV sedation. The anesthesiologist will use a combination of drugs to relax your body, relieve your pain, and help you not remember the procedure.

Medicines administered via the bloodstream begin to take effect quickly, often within minutes. Most people feel very relaxed at the start of IV sedation as the medicines begin to take effect. Many people remember the feeling of relaxation and waking up after the procedure is over but nothing in between.

There are different levels of IV sedation, and you may or may not be awake during the procedure. Your anesthesia team will adjust your sedation level throughout the procedure. Sometimes it is helpful to keep you awake during a procedure so you can move and follow directions. Other procedures may require you to be more deeply sedated.

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.

Your healthcare provider will give you instructions to help with your recovery, including when you can resume eating and drinking. Depending on the level of sedation used, and which drugs you were given, you may be advised to begin with liquids before moving to solid foods.

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.