Expert: Ronald Levy, M.D. - 4/15/2008

Question
QUESTION: What are the risks you would outline when opting for twilight anesthesia? I understand there is a bit of amnesia to be expected following a procedure under twilight and I did experience the amnesia for about 20 minutes following a 30 minute procedure. Is there a risk to extended memory loss following a longer procedure under twilight? The procedure may take as long as 6 hours. Thank you for taking the time to explain.

ANSWER: Amnesia is not necessarily related to length of procedure. The drug we give for sedation (Versed) can cause some amnesia for up to 12-24 hours. Each person is different. As for risks, there is always a risk that you will get oversedated and stop breathing intermittently. You might want to consider if you can stay still for 6 hours or would it be better to go to sleep. I would assume you are talking about some kind of plastics procedure. If general anesthesia is an option, I might souggest it.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: What are the benefits of "general" over "twilight?"

Thank you,

jvm

Answer
There is no discomfort, you don't need to worry about laing in one position without moving for a long time, your airway is protected. Twilite anesthesia is actually one of the hardest things for an anesthesiologist to do because you need to keep the patient right at the border of sleep and not sleep.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston