Intravenous (IV) Sedation Uses and Benefits

Intravenous (IV) sedation is a type of anesthesia (drugs that relax a patient and stop them from feeling pain) given through a tube placed in a vein. It is also known as monitored anesthesia care (MAC), conscious sedation, or in some cases, "twilight sleep."

There are different types of IV sedation. Depending on the surgical procedure, the amount of anesthesia used can range from a minimal amount (just enough to make a patient drowsy), to greater amount that puts the patient into a deeper sleep. Patients who receive heavier anesthesia may not remember the procedure afterward.

This article will discuss the types of anesthesia and when they are used, and what you should know if you are getting ready to have a procedure that requires you to be asleep.

Nurse holding an IV line
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Types of Anesthesia

There are four main types of anesthesia used during certain medical procedures or surgery. The types include:

  • Local anesthesia: Local anesthesia is an injection of medication that numbs a small area. This is used, for example, to remove a mole or skin cancer or to take a biopsy.
  • Regional anesthesia: Regional anesthesia is used to numb a larger section of the body. The anesthesia may be administered through an injection or a catheter. Patients will be awake but unable to feel the area that has been numbed.
  • Neuraxial anesthesia: Neuraxial anesthesia is a form of regional anesthesia administered between the vertebrae, such as a spinal or an epidural. This form of anesthesia is used during childbirth and often during hip and knee surgeries.
  • Monitored anesthesia (IV sedation): Monitored anesthesia, or IV sedation, is administered through a vein. Patients may be able to talk, depending on the level of anesthesia used, or instead be in a deep sleep. Patients are able to breathe on their own so that intubation (placing a tube into the windpipe) is not needed. IV sedation is used for a colonoscopy, some plastic surgery procedures, and increasingly for some procedures previously done with a general anesthetic, such a hernia repairs.
  • General anesthesia: General anesthesia is administered via inhalation of anesthesia gas through a face mask or intravenously. In addition to putting the patient into a deep sleep, the drugs also paralyze the muscles. Therefore, breathing is controlled with an endotracheal tube that has been inserted into the windpipe. General anesthesia is used for patients having major surgery, such as open-heart surgery.

Intravenous sedation is safe and effective for those patients needing minor surgery or a procedure to diagnose a medical condition (such as a biopsy).

Benefits

The benefits of using intravenous sedation during plastic surgery and other procedures include the following:

  • Ability to administer a more precise amount of anesthesia
  • A higher level of safety
  • Less incidence of postoperative nausea, vomiting, urinary retention, pulmonary complications and malignant hyperthermia (a life-threatening but rare complication of a general anesthetic)
  • Faster reversal (coming out of anesthesia)
  • Less risk of blood clots and pulmonary emboli (blood clots that travel to the lungs)

Because the patient is able to breathe on their own with IV sedation, both the surgeon and the anesthesiologist become aware of the patient’s discomfort before the patient does and can respond with an increase in the local anesthetic (drugs that stop pain) or level of sedation.

Risks

Heavy sedation may suppress the respiratory drive (slow down breathing) and requires careful monitoring of both respiration and oxygen saturation levels. If sedation is too deep, endotracheal intubation may become necessary.

Before a Procedure with Intravenous Sedation

Prior to undergoing a procedure with intravenous sedation, you should tell your doctor about allergies or medical conditions you have. You should also inform the doctor about any medications you are taking and any prior surgeries you've had, including the type of anesthesia used.

You should also ask whether an anesthesiologist or a nurse anesthetist will be administering anesthesia as their medical background and medical training is different.

You may need to arrange for a responsible adult to drive you to and from the facility for the procedure.

Follow any instructions provided to you prior to surgery, including restrictions on food and drink. Avoid drinking alcohol the day before or the day of your procedure as it can affect anesthesia.

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.

After a Procedure with Intravenous Sedation

Most often, 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. You will usually be observed for one to two hours after the procedure before you will be able to return home with your driver.

Frequently Asked Questions

How much does IV sedation cost?

The price for IV sedation can vary, depending on where your procedure is performed. Your doctor and their staff will be able to discuss with you how much your procedure will cost, including the anesthesia.

What drug is used during IV sedation?

There is no single drug used during IV sedation. In fact, the anesthesiologist (the doctor who administers anesthesia) will use a combination of drugs to relax your body, relieve your pain, and help you not remember the procedure.

How long does IV sedation last?

It depends on how long your procedure lasts. Because the medicines are given through the bloodstream, IV sedation takes effect quickly. Your anesthesiologist will monitor medication levels throughout the procedure, and remove the IV at the appropriate time. Once the medicines are stopped, patients wake up shortly thereafter and recover in about a day.

Why should I not smoke before undergoing IV sedation?

Smoking doesn't just affect the lungs; it also impacts how our hearts function. Complications from smoking—including heart disease, high blood pressure, and breathing issues—can interfere with how your body processes anesthesia and can even impact your recovery.

What does IV sedation feel like?

The majority of people will feel very relaxed at the start of IV sedation as the medicines begin to take effect. For many people, they remember the feeling of relaxation and the feeling of waking up after the procedure is over, but nothing in between.

How quickly does IV sedation begin to work?

Medicines administered via the bloodstream begin to take effect quickly, often within minutes.

How long should I wait to eat after IV sedation?

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

A Word From Verywell

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.

Certainly, all forms of anesthesia have risks, and it's important to talk to your surgeon and anesthesiologist about any medical conditions which you may have, as well as care for yourself after the procedure and follow the instructions you receive.

Quitting smoking is probably the number one thing anyone who smokes can do both to increase the safety of anesthesia and the healing from any surgical procedure.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. National Library of Medicine: MedlinePlus. Anesthesia. Updated January 6, 2020

  2. Sohn HM, Ryu JH. Monitored anesthesia care in and outside the operating room. Korean J Anesthesiol. 2016;69(4):319–26. doi:10.4097/kjae.2016.69.4.319

  3. Das S, Ghosh S. Monitored anesthesia care: An overview. J Anaesthesiol Clin Pharmacol. 2015;31(1):27-9. doi:10.4103/0970-9185.150525

  4. American Society of Anesthesiologists. IV/Monitored sedation.

  5. Cleveland Clinic. 3 Reasons why smoking before surgery isn't an option. Updated August 5, 2020.