Monitored anesthesia care
At other times, the surgeon injects a local anesthetic agent or the anesthesia provider performs a peripheral nerve block for intraoperative and postoperative analgesia, and MAC is provided so that the patient has the highest level of monitoring possible and the anesthesia provider is available to intervene to maintain the patient’s vital functions, with the option to convert the MAC to a general anesthetic, if necessary. This is a critical difference between MAC and moderate (conscious) sedation; the latter refers to a situation in which a physician supervises another healthcare provider, who monitors the patient and administers sedative and analgesic drugs under the supervising physician’s direction while the supervising physician performs a procedure, or the physician may administer drugs himself or herself. The type and amount of medication administered to a patient are supposed to achieve a “moderate” level of sedation such that the patient’s vital signs and respiratory drive are not significantly altered. Accordingly, the healthcare provider who administers moderate sedation must know how to monitor a patient’s vital signs and be able to recognize the transition into deep sedation.* In this event, the provider must understand how to support the patient’s vital functions and to increase the level of consciousness so that the level of sedation is again “moderate.”
