Sedation and anesthesia

We match the type of comfort medicine to the procedure and to you. Almost every procedure starts with local numbing at the skin. Many add sedation through your IV. A few need full anesthesia.

Local anesthesia, usually lidocaine, numbs a small area of skin and the tissue underneath. You feel a small pinch and a few seconds of burning as it goes in, and then the area goes numb within about a minute.

After that, you may still feel pressure, pushing or tugging, but not sharp pain. If you feel pain, tell us and we will add more numbing medicine. With local anesthesia alone, you are fully awake, and you can usually eat, drink and drive afterward.

Moderate sedation, sometimes called conscious sedation or twilight sleep, is the most common choice for IR procedures. A nurse gives you two medicines through your IV: one that relaxes you and dulls memory, usually midazolam, and one that eases pain, usually fentanyl. They start working within 1 to 2 minutes.

You breathe on your own and can answer questions or change position if we ask. Many patients doze off. Most remember little or nothing of the procedure afterward, though some remember parts of it. Small extra doses can be given at any time if you are uncomfortable.

A nurse trained in sedation stays with you from start to finish, watching your heart rhythm, blood pressure, breathing and oxygen level on a monitor. Your doctor directs the doses and can reverse both medicines quickly if needed.

Some procedures are long, uncomfortable, or need you to stay completely still or hold your breath precisely. Some patients also have health issues, such as severe sleep apnea, lung disease or trouble lying flat, that make an anesthesia team the safer choice.

In those cases, an anesthesiologist or nurse anesthetist gives deeper sedation or general anesthesia and manages your breathing. You will meet them before the procedure. Recovery usually takes a little longer.

Sedation medicines leave your body slowly. For the rest of the day your reaction time, balance and judgment are affected, even when you feel completely normal. That is why you need a responsible adult to take you home. A taxi or rideshare alone is not allowed. If you do not have a driver, your procedure may be rescheduled.

It is best to have someone stay with you overnight. Start with light food and fluids, then return to your usual diet. Read more in our recovery guide.