Sedation and General Anesthesia: What’s the Difference?
While it is common in the hospital setting, sedating a child or teenager is never treated as routine. Because of advances in medications, monitoring and training, anesthesia is safer today than it ever has been. But pediatric and adult anesthesia are not the same, and neither are sedation and general anesthesia. It’s good to understand how they differ.
Several variables make pediatric anesthesia different from adult anesthesia. One is the incredible diversity of size and age of pediatric patients. Children have significant differences in growth and development both physically and emotionally. A 6-pound infant will have vastly different anesthesia needs than will a 180-pound teenager. And a fearless 3-year-old might react differently to an IV needle than a timid 10-year-old.
We take all of that into account when deciding what anesthesia will be best for each child. We also consider type, location and length of the procedure; the child’s overall medical history; allergies; medications; and any previous reactions to anesthesia.
How Are Sedation and General Anesthesia Different?
In talking about sedation and general anesthesia, it helps to think about levels of consciousness on a spectrum. At one end of the spectrum, the patient is completely awake with no sedation. At the other end, the patient is under general anesthesia and is fully unconscious. Sedation falls in between.
In general, sedation is considered a “lighter sleep.” When under sedation, children are unaware of their surroundings, but might respond to stimulation, such as being asked to open their eyes. There are different levels of sedation: mild, moderate and deep.
Sedation is often used for minor procedures such as suturing a laceration in the Emergency Department. We also use sedation during non-painful procedures when children need to be still for long periods of time, such as during a long imaging procedure, most commonly MRI.
With general anesthesia, children are completely unaware of their surroundings and are not responsive to any stimuli. General anesthesia is typically used for surgery, but it is also commonly used outside the operating room.
A brief general anesthesia is often used for diagnostic procedures such as a flexible bronchoscopy, upper and lower endoscopy, bone marrow aspirate or lumbar puncture, as well as many longer MRI imaging procedures when the child is unable to lay still.
Q&A At a Glance
Safety Is Our Utmost Concern
Sedation is a carefully monitored and regulated process. Practitioners must be certified in sedation and undergo rigorous credentialing. Both sedation and general anesthesia are safe and effective for children undergoing procedures, thanks to the medications we use as well as the skill and training of our anesthesia providers.