![]() ![]() Propofol, a short-acting anesthetic agent that is rapidly titratable, is currently the premier agent chosen to achieve this purpose. 3 Hypnotic agents may be employed during MAC to bring the patient to a level of deep anesthesia/analgesia. The ability of the patient to speak and understand is useful not only as a monitor of sedation depth and cardiorespiratory function but is also necessary to offer reassurance and communicate to the patient when active cooperation is required during the procedure (eg, breath holding). There is a common armamentarium of drugs shared between providers of moderate sedation and MAC, all given with the intent of maximizing anxiolysis and amnesia while maintaining a verbal patient. 1 Copyright © 2002 wolters Kluwer Health. An updated report by the American Society of Anesthesiologists Task Force on sedation and analgesia by non-anesthesiologists. Reproduced with permission from Practice guidelines for sedation and analgesia by non-anesthesiologists. Patients often require assistance in maintaining a patent airway and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Patients may require assistance in maintaining a patent airway and spontaneous ventilation may be inadequate.Ī drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation.Ībility to independently maintain ventilatory function is often impaired. No interventions are required to maintain a patent airway and spontaneous ventilation is adequate.Ĭardiovascular function is usually maintained.Ī drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation.Ībility to independently maintain ventilatory function may be impaired. Ventilatory and cardiovascular functions are unaffected.Ī drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. ![]() The scope of MAC is significantly wider, including the necessity of a preoperative evaluation, an anesthesiologist’s personal participation or medical direction of the entire plan of care, and the ability to rescue a patient from unintended deep sedation or to intentionally provide deep sedation or general anesthesia if clinically warranted.Ī drug-induced state during which patients respond normally to verbal commands.Ĭognitive function and coordination may be impaired. 1 Moderate sedation is not synonymous with monitored anesthesia care (MAC) the former can be administered by anyone capable of giving the medications and monitoring the patient, 2 while MAC must be performed under the medical direction of an anesthesiologist. A patent airway, as well as stable cardiac and respiratory functions, are maintained throughout the period of sedation ( Table 1). Moderate sedation as defined by the American Society of Anesthesiologists (ASA) requires that the patient be arousable to verbal commands or light tactile stimulation. The concept of moderate sedation and analgesia, introduced to replace the more arcane term conscious sedation, has been generally accepted in the anesthesia community as an appropriate target for sedation by nonanesthesiologists.
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