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What is Local Stand-By?
Local
Stand-by is also known as twilight anesthesia wherein you
will be "asleep" but not unconscious.
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Effects of Local Stand-By
This
procedure provides a light sleep, anxiety relief, and
amnesia (loss of any memories of surgery). Twilight sleep
alone is not used to provide relief from surgical pain, it
is always given in conjunction with a
local or
regional anesthetic. It also offers a
limited recovery period, and it is usually associated with
less nausea and vomiting compared to general anesthesia.
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Candidates for Local Stand-By
Local stand-by procedures are used for simple or minor
procedures or for those patients who prefer to be completely
awake.
Whether or not you have twilight anesthesia will depend on
the type and length of the surgery.
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Your
Consultation
The usual instruction is not to eat or drink anything after
midnight before surgery. Most patients should continue to
take regularly scheduled medications up to and including the
morning of surgery. Prior to surgery, discuss all
medications you take with your doctor.
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The Local Stand-By
Procedure
Some
of the same drugs that are used for general anesthesia are
also used for in this procedure, except in smaller doses.
These drugs can either be administered through gases or
intravenously. Breathing tubes are not usually used for this
type of anesthesia.
During the procedure, the anesthesia specialist delivers
different amounts of sedation and anesthetic medication
through an intravenous (IV) line, while monitoring the
patient's comfort level and increasing and decreasing the
medication as needed. Throughout the entire procedure, your
vital signs and other bodily reactions will be monitored
with a blood pressure cuff, heart rate monitor, pulse
oximeter and an EKG machine. This is normally combined with
an injection of local anesthetic at the surgical site for
more pain control and also to lessen bleeding.
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Recovery
It is recommended that you have someone stay with you at
least for the first 24 hours after your surgery. If your
procedure requires anesthesia combined with any form of
sedation, you will need someone to drive you home after
surgery.
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Risks
Side effects like nausea, vomiting, sore throat or
disorientation that are typically associated with general
anesthesia are virtually non-existent with twilight
anesthesia.
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Frequently Asked
Questions
Q: What
is twilight anesthesia?
A:
Twilight anesthesia involves the use of IV sedation. With
twilight anesthesia, the patient is kept sedated throughout
the procedure. After the procedure, the patient is easily
awakened for a speedy discharge to recover at home.
Q: Will I
sleep talk while under twilight anesthesia?
A:
There is a misconception that sedation acts like a "truth
serum" and that it makes the patients divulge secrets and
embarrassing personal details. The truth is, the sedated
patients sometimes become a bit disinhibited and this could
be an embarrassing experience. However, the amnesia effect
means that you are unlikely to remember what you said.
Q: Who administers anesthesia?
A:
There are several specialists who can administer anesthesia.
usually, the doctor performing the surgery can administer
local anesthetics. Monitored Anesthesia Care may be
administered by a registered nurse, an anesthesiologist or a
nurse anesthetist. General anesthesia though, requires an
anesthesiologist or a nurse anesthetist.
Q: Will
certain drugs interact with the anesthesia?
A:
Yes, many prescription
medications, over the
counter medications and herbal remedies interact with
anesthesia and can even cause adverse affects during and
after surgery. It is very important to discuss all
medications and herbal remedies you are taking with your
doctor before the surgery. Depending on your condition, the
medicine may be discontinued prior to surgery, or the dosage
of anesthesia may be adjusted to accommodate for the
anticipated variations of medicine levels in your
bloodstream at the time of your surgery. Do not stop taking
a prescribed medication without discussing it with your
doctor first.
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