Is General Anesthesia Safer Than Sedation?

First of all, thank you for your patience and kindness. I have been told that general anesthesia is safer because during sedation, the patient can stop breathing and the heart rate is not monitored. Is that true or it depends on the individual?

Doctor Answers 10

Both General Anesthesia and IV Sedation Are Safe

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General anesthesia and IV sedation are both very safe and effective. Here are some things to think about:

Very Important
  1. Make sure that you will be completely monitored including O2 saturation, pulse, blood pressure, CO2 level in exhaled air, core temperature and EKG.
  2. For any procedures (over 2 hours) sequential compression stockings are used to help decrese the risk of blood clots.
  3. Make sure their is a crash cart for resusitation if needed.
  4. Make sure the center has Dantrolene in stock if you have never had surgery before (just in case you develop a very rare condition called malignant hyperthermia)


  1. How Experienced is the Doctor or nurse doing the anesthesia
  2. Which do they use most often?
  3. Is there a hospital close by just in the rare instance of and allergic reaction or unknown heart problem crops up.
  4. Is the setting a hospital or ambulatory surgery center and not just a extra room in their office.
Which type of anesthesia to use: quick guide
  1. Body cosmetic surgery - I usually use general
  2. Facial cosmetic surgery - I usually use twilight(IV Sedation)
  3. A patient with heart or lung problems - I usually use general
Ask the above questions and find out your surgeons reccomendations and you should be able to obtain a safe anesthetic with either General anesthesia or IV sedation.

Sedation versus general anesthesia

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For both sedation and general anesthesia, patients are monitored carefully. Patients seem to worry alot about general anesthesia. However, it is probably safer than sedation for longer cases and controlling the airway is performed during general anesthesia where patients undergoing sedation may fluctuate from breathing well to being oversedated.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Type of Anesthesia

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It really depends on what is being done and how long it will take. In general, I prefer general anesthesia because I like the anesthesiologist to be controlling the patients airway, rather trying to play a tight rope between not having the patient feel anything and allowing the patient to breath on their own.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

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Anesthesia During Surgery

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There are different types of aneshtesia available. Mac anesthesia and general anesthesia can both be safe when performed by a board certified anesthesiologist. In my practice, an MD board certified anesthesiologist remains at the bedside of my patient throughout surgery. I think this is the safest approach and that it provides peace of mind for patients and their families. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
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General Anesthesia vs Sedation for Cosmetic Surgery

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General anesthesia isn't what it used to be. Previously an endotracheal tube was placed into the trachea requiring a paralytic and full sedation. Nowadays a patient is given just enough sedation to be asleep but still breathing then an LMA is placed into the back of the throat. Although the patient is under "general anesthesia" they are still breathing on their own and the airway is protected.

With sedation all monitoring is the same as far as cardiac rhythm, blood pressure, oxygen saturation etc. However, the patient must be given enough sedation to sleep but continue to breath. There is no tube in the throat so the airway is not protected. If too much sedation is given the patient can stop breathing and a mask must be placed for manual breathing.

The long and short of it is that today's general anesthesia is much safer than sedation because the airway and thus the patient's ability to get oxygen to the lungs is protected.

Anesthesia for Cosmetic and Plastic Surgery

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Both IV sedation (twilight) and general anesthesia are used commonly for cosmetic or plastic surgery. Regardless of technique, the patient's vital signs must be monitored, which include but not limited to heart rate, blood pressure, and breathing rate. In addition, both types of anesthesia should be provided by board-certified anesthesiologist.

Your specific type of anesthesia should be discussed with your plastic surgeon and anesthesiologist. One anesthesia method is not necessarily better or safer than another for all patients or surgeries. Best of luck.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Choice of anesthesia: general or local

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There are several different factors tham play a role in deciding whether one anesthetic technique is safer than another. However, as a surgeon, I generally prefer to have an anesthesiologist make the decision with the patient unless the procedure is relatively minor and can be accomplished under straight local or local with oral sedation.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Tough to measure but...

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I think for mild sedation ( a small dose of say valium), would be safest.  However, my preference (agian, others may disagree) would be general anesthesia over deep sedation.  Although both are monitored, it is reassuring that the airway is controlled under general.

Safety of general anesthesia vs sedation or twilight anesthesia

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If you are sedated enough to be asleep, technically you are under a general anesthetic (GA) without your airway protected. HR and BP and oxygen levels are monitored in both situations along with many other safety parameters. Rather than ride a roller coaster of not enough sedation to too much sedation, most physician anesthesiologists prefer a light general anesthetic with an LMA which is a mask airway in the mouth and not down the throat. That way, you will be totally comfortable and your airway will be protected throughout.

Be careful about doctors who speak strongly against GA because they often are not real plastic surgeons and can't get MD anesthesiologists to work with them so they try to scare the patients into thinking that GA is more dangerous than sedation!

Safety of general anesthesia

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The reason that you may have heard that general anesthesia is safer than sedation has nothing to do with monitoring heart rate really. Heart rate is monitored in both situations. Some anesthesiologists consider it safer because during general anesthesia your airway is protected with either a tube or mask (LMA or Laryngeal Mask Airway) placed in your throat. So, if you were to stop breathing during surgery (from paralysis or heavy sedatives) the anesthesiologist still has a way to ventilate you or push air into your lungs. The general endotracheal tube (GET) method of general anesthesia will also prevent fluids from your stomach, saliva, blood from the nose, etc, from getting into your lungs and causing damage.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.