What is twilight sleep?
Twilight sleep is a state of consciousness just below the waking state. It is a certain stage of sedation. The affected person sleeps or has his eyes open and is not fully focused.
The affected person can be awakened all the time by loud speech or pain. It is artificially induced by certain drugs. The central nervous system is dampened by medication.
Benzodiazepines, such as midazolam, can be used for this. Twilight sleep is often used in combination with local anaesthetics and painkillers during unpleasant examinations or minor operations. Twilight sleep is one way to reduce the physical and psychological stress of medical procedures.
If medically necessary, the health insurance company bears the costs of twilight sleep. After an intervention in twilight sleep, the patient must be picked up by a previously determined relative or friend and is not allowed to drive motor vehicles for 24 hours. In rare cases, affected persons react paradoxically to the medication and become restless.
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Indications for a twilight sleep anaesthesia
A twilight sleep anaesthesia is used for mental and physical relaxation and is intended to reduce stress for the patient during medical interventions. A twilight sleep anaesthesia is used, for example, in diagnostic procedures. Colonoscopies and gastroscopy are often described by patients as a very unpleasant experience and this can be prevented by the use of twilight sleep anaesthesia.
In gastroscopy, the perception of the gag reflex is prevented and in colonoscopies the examination is described as less painful. The procedures also seem to be significantly shorter for the patient. For children or persons with fear of confined spaces, twilight sleep anaesthesia is also performed during MRIs or CTs, as the person must lie still.
A frequent use of twilight sleep anaesthesia is dental surgery, such as the removal of wisdom teeth. Twilight sleep anaesthesia can also be used for operations with spinal cord anaesthesia, so that the person affected does not perceive the sounds in the operating theatre as much. Visits to the dentist are associated with fear for many people.
Dental operations are often only performed under local anaesthesia, whereby consciousness is completely retained. The affected person hears all sounds, tastes the blood in the mouth and clearly perceives pressure on the jaw. This is both physically and psychologically exhausting.
Some dentists therefore offer their patients to perform major procedures under a twilight sleep anaesthesia. During the procedure, the patients remain awake on response and breathe independently. However, conscious perception of the surroundings is limited, so that fear and stress are reduced.
The twilight sleep anaesthesia is used especially for larger operations, such as the removal of wisdom teeth. In gastroscopy, a camera is inserted through the mouth into the oesophagus. Although the mouth and throat are locally anaesthetized, many patients still notice a strong gag reflex.
The examination is often described as unpleasant. In this case, the patient can be given a twilight sleep anaesthetic to ensure that he or she can survive the procedure without stress. The procedure itself lasts only a few minutes, but sedation means that no motor vehicles may be driven for 24 hours after the procedure.
Colonoscopy was once described by many patients as a terrible experience, which led to much fear of the procedure. Today, the reports of experiences after colonoscopies are much more positive and those affected report that they slept through the procedure. This is due to the twilight sleep anaesthesia that is almost always performed today. Those affected hardly notice the sometimes painful procedure and are much calmer. The sedation for colonoscopies is usually covered by health insurance companies.
