Twilight sleep is a type of anesthesia that minimizes pain and reduces awareness of a procedure, inducing an amnesiac condition. Originally used in obstetrics, it is no longer used due to unwanted side effects, but similar techniques are still used in other medical procedures. The degree of unconsciousness varies, but patients may have little or no memory of the procedure or pain experienced.
Historically associated with childbirth, the term twilight sleep is often used to describe a modality of anesthesia in which a patient undergoing any type of painful procedure is given a cocktail of drugs that minimize pain and reduce awareness of the event. In many cases, twilight sleep induces an amnesiac condition so that the patient does not remember the procedure or any discomfort experienced after the anesthetic drugs wear off. This type of anesthesia was originally introduced in the obstetrics area as a way to minimize the discomfort of women during childbirth. Although the original combination of drugs, morphine and scopolamine is generally no longer used, other drugs that can have a similar analgesic and sedative effect are commonly offered to patients in a variety of medical and dental procedures.
At the beginning of the 20th century, German doctors published information about their work in obstetric anesthesia. The goal of twilight sleep was to reduce the laboring woman’s stress and discomfort and allow her to completely forget the experience. After labor and delivery were complete, she might be presented with her new baby and have no memory of the labor experience. Twilight sleep continued to be used for several decades in maternity wards, despite unwanted side effects, such as making women behave so erratically that restrictions were required. Some women also complained that, having no memory of giving birth, they felt disconnected from their children; Babies born to mothers on twilight sleep medications often developed breathing problems.
Eventually, the trend towards so-called natural childbirth and new anesthetic techniques that allowed women to remain conscious during childbirth meant that twilight sleep was no longer used in obstetrics. Other doctors, however, continue to use anesthetic techniques that work on a similar principle to twilight sleep. Sometimes known as modern intravenous sedation, intravenous sedation, or light sedation, it is typically indicated for individuals undergoing a painful medical procedure that does not mandate the use of a riskier general anesthesia. In some cases, intravenous sedation is offered to patients who fear having a procedure that might be done under local anesthesia, such as a tooth extraction.
The degree of unconsciousness experienced by individuals undergoing modern twilight sleep anesthesia varies considerably. In many cases, however, the individual will be able to understand and respond to verbal instructions offered by healthcare professionals. For example, a person who is under the influence of IV sedation may be able to dress themselves after a procedure and get into a wheelchair to be wheeled to a recovery room with minimal assistance. Yet this individual may have little or no memory of the procedure or the pain experienced.
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