Is Awake Anesthesia Really Safer than General Anesthesia?

883717_10151921513905861_392109913_oOne of the most common questions that I am asked is, “How safe is anesthesia and which form is the safest?” My patients are literally bombarded with information regarding not only various types of anesthesia but also opinions regarding which form is the safest. And while information can be helpful, the problem is that much of this information is biased and often inaccurate.

A good example of this is IV sedation or “awake anesthesia” as many people refer to it. This form of anesthesia involves administration of a sedative drug through an IV but without placement of an airway. And because there is no formal intubation, some surgeons suggest that it is safer. And this is not true. There is no study that I know of documenting that IV sedation is any safer than General Anesthesia. In fact, many anesthesiologists (who administer anesthesia every day all day long) have told me that General Anesthesia is actually the safer option because your airway is protected, there is little to no risk of being aware of the surgery, and there are not the wide fluctuations in alertness as there can be with awake sedation.

So why do some surgeons promote one type of anesthesia over another? The sad truth is that they may not have your best interests in mind when making this decision. The choice may be economic or it may just be that they cannot perform General Anesthesia in their office and so they are promoting the only type of anesthesia that is available to them. This is actually a very common ploy among Cosmetic Surgeons (physicians who are NOT Plastic Surgeons but perform plastic surgery procedures). These physicians commonly usually cannot get privileges in either hospitals or surgery centers because of their lack of formal Plastic Surgery training and so they choose to operate out of an office OR. When they do so, many of them are not set up for General Anesthesia and so IV Sedation is the only option available to them. And since this is the only thing they can do, they justify and promote to you that their way is much safer; when in reality, it is not.

And so is IV Sedation a bad form of anesthesia? Absolutely not! But the point here is that it is no safer than General Anesthesia despite what many practitioners are preaching.

I hope this information has been helpful and look forward to hearing your questions and feedback. Please feel free to either post here or send me a private message at [email protected]

Thanks again for your continued support!