General Anesthesia versus Twilight Sedation

Interested to learn why people go with one option over the other for their PS. Would love to know other's experience on this. I understand twilight sedation is epidural plus some kind of sleep aid (but you breathe on your own?).
Still learning and researching and would love to hear from others about this!
Thanks!! 

I just had twilight sedation - also known as intravenous sedation - on Wednesday for my arm lift surgery and will never choose general anesthesia again if I have a choice.  I've had a number of surgeries with GA and it took me days to feel like "me" again whereas I walked out of the hospital on my own just three hours after waking up and I felt great!

The worst part was the painful sting of the I.V. going into the underside of my forearm - that burned like a son of a gun at first but it was only moments and I was off to la la land anyway.

Waking up was a bit unusual as well.  I felt like I was a character in a video game and was fighting my way through forests and walls made of blue and green curtains.  I realized later that those colours were what the nurses were wearing so I guess my eyes fluttered open long enough to see that and drift back and incorporate it into my snoozing.

So overall I highly recommend twilight sedation and plan to use it again in January for my breast lift.

Happy decision making!

Mickie

 Thanks for the response Mickie!
One thing that worries me (probably silly, but still), what if I wake up in the middle of surgery? And, couldn't you feel the surgery happening?

I'm glad your surgery went so well, congrat's!!
 

This is the single most common question that gets asked and NO you will NOT wake up during surgery......ever!  And it is impossible to feel anything.  Just like a general but better :)

Mickie

 Thanks for putting my mind to rest on these worries Mickie! It seems like it's the way to go. I've heard very few surgeons offer twilight sedation though, do you know why this is?

Hi Mickie.

I wish this were true but according to at least one published study of 84 twlight anesthesia patients:

"The midazolam/fentanyl sedation group had more recall of "unpleasant intraoperative events" (17 percent versus 3 percent, p = 0.007). However, both groups had low recall of intraoperative pain, anxiety, and nausea. The propofol infusion group experienced significantly more nausea in the recovery room (p = 0.002), nausea at the time of discharge (p = 0.009), and nausea the evening after the operation (p = 0.013). "

That being said, I am glad you were not one of the 17% of patients with recall, pain, or nausea !

I had twilight too.   Never General again.   I was out 13 hours, lots of work done, woke up like from a nap.  I would highly recommend it.

Bonnie

 Hi Bonnie, thanks for the response! I was wondering about your surgery - how many procedures did you have done at the one time? I was hoping to have either LBL or tummy tuck, brachioplasty and breast lift/ augmentation all at the one time.
Who was your surgeon if you don't mind my asking? I don't think very many offer twilight sedation, but I'm not positive of this yet either..

I had a large anchor cut, a lift with gummy bear implants and a neck lift.  I've had several 'generals' before, all left me with several weeks of feeling out of it.  Not remembering names, places.. very disoriented.   This time, it was like a nap.   No issues.  I'd highly recommend it. 
I had Dr. Sauceda in Monterrey, Mexico.   He's got a board on here where you can read several patients stories and watch things happen in real time.  Price for me was $11,400 that's with my $600 flight credit and implants included.  Hotel costs are also covered and transportation to and from the airport.  Check out some photos of his patients, you'll see what an artist he is.
www.obesityhelp.com/group/Dr_Sauceda_Patients/discussion/ 

Bonnie

 Thanks for all this information Bonnie.. I'll check Dr Sauceda out. I had my WLS in Mexico with Dr Ungson, so I'm open to this for PS too.