What Is the Difference Between Sedation and General Anesthesia?

Sedation and general anesthesia are used for different surgical procedures, with general anesthesia reserved for the more serious and invasive ones.

Both sedation and general anesthesia are used for different types of medical and surgical procedures. 

The difference between sedation and general anesthesia is degrees of consciousness. 

Sedation is a sleep-like state where patients are generally unaware of surroundings but may still respond to external stimuli. General anesthesia is a form of a temporary medically induced state of unconsciousness in which pain control and amnesia are induced, and patient’s airways may be taken over and monitored by a doctor, rather than patients breathing on their own.

Minimal sedation (anxiolysis):

• Patients respond normally to verbal stimulation
• Cognitive function and coordination may be minimally impaired
• Breathing and cardiovascular functions are unaffected

Moderate sedation/analgesia (also referred to as twilight sedation or conscious sedation):

• Drug-induced reduction of consciousness
• Patient can still respond to verbal commands
• Patient is easily aroused and is able to respond purposefully following tactile stimulation
• Breathing is not affected and patients can breathe on their own
• Cardiovascular function is usually unaffected

Deep sedation/analgesia:

• Drug-induced reduction of consciousness
• Patient is not easily aroused and is not able to respond purposefully following repeated or painful stimulation
• Independent breathing may be impaired and patients may require assistance in maintaining open airways
• Cardiovascular function is usually maintained

General anesthesia is characterized by:

• Drug-induced loss of consciousness, and patient is unable to be aroused, even by painful stimulation
• Breathing is impaired and patients require assistance to maintain open airways, and positive pressure ventilation may be required 
• Cardiovascular function may be impaired

Sedation is used for procedures such as:

• Dental procedures
  • Filling cavities
  • Root canal
  • Tooth extraction
  • Cleanings for sensitive individuals
  • Dental implants
  • Cleanings in sensitive patients
  • Filling cavities cavity filling
• Medical examinations using a scope
  • Colonoscopy
  • Endoscopy
  • Bronchoscopy
• Minor surgical procedures
  • Biopsies
  • Minor bone fracture surgery
  • Cardiac ablation procedures 
  • Electrical cardioversion
  • Minor skin surgery
  • Vasectomy
• Fix a dislocated joint
• Lumbar puncture 
• Radiation therapy

General anesthesia is most often used for major surgical procedures that:

• Take a long time 
• Could affect a patient’s breathing
• Involve exposure to a cold environment
• Involve a major organ such as the heart or brain
• Involve opening or operating in the abdominal cavity
• Are performed over a large area of the body
• Have potential for considerable blood loss

Risks and side effects of sedation and general anesthesia include:

• Low blood pressure (hypotension)
• Low blood oxygen (hypoxia)
• Respiratory depression
• Slow heart rate
• Irregular heartbeats
• Sore throat
• Headache
• Shivering
• Becoming more deeply sedated than intended
• Need for assisted ventilation
• Intubation
• Procedure may not be effective (not enough anesthesia)
• Emergence delirium (in children) 
• Allergic reaction
  • Swelling
  • Rash
  • Sore throat 
  • Nausea
  • Vomiting