<P> In this level called Anesthesia, a combination of general anesthesia and spinal or major regional anesthesia . It does not include local anesthesia . Ventilatory function is often impaired and cardiovascular functions may be impaired . </P> <P> Several factors are taken into consideration when determining which level of anesthesia is used under which type of medical procedures . Along with the factors determined, different types of anesthesia medications are used depending on the medical procedure being done . While the patient is under level two of sedation by anesthesia, depending on the type and dose administered, they are in a state that is known as a "twilight" state, thus attaining the name "twilight anesthesia ." </P> <P> The same drugs used in general anesthesia are also used for twilight anesthesia, except in smaller doses and in a bolus interval (A concentrated mass of a substance administered intravenously for diagnostic or therapeutic purposes). These drugs can be administered via gases, such as nitrous oxide (laughing gas), or intravenously, with drugs such as ketamine (pediatrics primarily, and infrequently in adults), propofol, and midazolam . Twilight anesthesia alone is not used to provide relief from surgical pain, therefore, it is always given in conjunction with a local or regional anesthetic . Additionally, IV sedation is frequently administered as a concoction of several agents including those previously mentioned for induction and maintenance of anesthesia, as well as a benzodiazepine (usually midazolam, but temazepam or flunitrazepam are also used via the oral route) and a narcotic / systemic analgesic such as demerol or fentanyl . As discussed in the levels of sedation by anesthesia, assistance with breathing tubes (ETT or LMA) are not generally used for this type of anesthesia . </P> <P> A few studies have been geared towards studying the effects of post operative analgesic regimes that measure the quality of recovery period and health - related quality of life . Factors other than degree of analgesia and presence of analgesic agent - related side effects (e.g., fatigue, physical functioning, and mental health) may potentially influence these outcomes . Twilight anesthesia offers a limited recovery period after procedures, and is usually associated with less nausea and vomiting than general anesthesia which makes it a popular choice among doctors who are performing procedures such as minor plastic surgeries . </P>

What do they give you for twilight sleep