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Asleep, Twilight, Spinal or Local? Sedation Types

Four ways to keep you comfortable during surgery — and the big question they answer is simply: how awake will you be? Tap any option below to see what it is, what you feel, and when it's used.

Which one are you curious about?

Pick an option to read its clear card, or choose “Compare all four” to see them side by side.

How is mine decided?

Which type you have depends mostly on the operation itself — some surgeries only work one way, others give you a choice. Your anesthetist weighs the procedure, your health, and your preferences, and talks the plan through with you beforehand. If you're anxious or have a preference, say so early: there's often room to adjust.

Want more depth? Read types of anesthesia explained, spinal anesthesia, and epidural anesthesia.

How awake will you be?

The four options on one scale — from fully asleep to fully awake.

Less aware Fully awake General fully asleep Sedation twilight / drowsy Regional awake, numb area Local fully awake
The real question each one answers: how awake will you be? Tap a card above for the details.
Medically reviewed by Dr. Saurabh Shukla, MBBS, DNB Anesthesiology · Last updated June 2026

Frequently asked questions

What is the difference between being fully asleep and twilight sedation?

General anesthesia makes you completely unconscious with no awareness at all. Twilight sedation (also called MAC) makes you deeply relaxed and drowsy through an IV — you may doze and remember little, but you are not as deeply under and are more easily roused. Twilight is used for lighter procedures.

Will I feel pain with a spinal or epidural?

No. A spinal or epidural numbs a whole region — usually everything below the waist — so you feel no pain there. You stay awake or lightly sedated. You may notice pressure, movement, or tugging, but not sharp pain.

Am I awake with local anesthesia?

Yes, fully awake. Local numbs only a small, specific spot — like the area being stitched or a tooth being filled. You feel the brief sting of the numbing injection, then nothing sharp in that spot.

Who decides which type of sedation I get?

Your anesthetist (anesthesiologist) decides with you, based on the surgery itself, your health, and your preferences. Some operations only work with one type; others give you a choice. You can always ask what is planned and why.

Can I ask to be more asleep if I'm anxious?

Often yes. With sedation and regional anesthesia you can usually ask to be as relaxed and drowsy as is safe for your procedure. Tell your anesthetist beforehand — they can adjust the plan or add medication to keep you calm.