Monitored Anesthesia Care (MAC)

Monitored anesthesia care is a type of anesthesia where an anesthesiologist accompanies the patient during their surgical procedure to help manage pain and reduce anxiety. Commonly used for simple procedures that can be completed quickly, this method helps reduce painful sensations and limits the awareness of pain.

What Is Monitored Anesthesia Care (MAC)?

Monitored anesthesia care, also known as MAC anesthesia or MAC sedation, refers to an approach where an anesthesia provider accompanies and closely monitors patients throughout medical or surgical procedures. The anesthesiologist administers sedative and pain medications in carefully measured amounts that are tailored to the individual patient's needs. The primary goals of monitored anesthesia care are to ensure patient comfort, manage pain, and reduce anxiety during the procedure.

Depending on the requirements of the procedure and the patient's medical condition, MAC anesthesia utilizes varying degrees of sedation, ranging from moderate to deep sedation. Moderate sedation typically allows patients to remain conscious and responsive during the procedure. Patients under moderate sedation can communicate with the anesthesia provider and respond to verbal cues, which enables them to convey any discomfort or pain they might experience.

On the other hand, deep MAC sedation induces a state of unconsciousness, rendering the patient unaware of their surroundings. This level of sedation is often used for more lengthy procedures when it is necessary to ensure the patient's complete comfort and immobility.

Regardless of the level of sedation required, the anesthesiologist closely monitors vital signs and other important parameters throughout the procedure and recovery. This includes continuous monitoring of heart rate, blood pressure, breathing, oxygen saturation levels, and the patient's level of alertness.

The anesthesia provider's role is crucial, as they are responsible for adjusting the dosage of medications to maintain the desired level of sedation and pain control. They also ensure the patient's safety by monitoring for any adverse reactions or complications that may arise.

When Is Monitored Anesthesia Care Used Over Other Types of Anesthesia?

Monitored anesthesia care is used for procedures such as joint arthroscopy, fracture reductions, closed reductions of dislocations, tendon repairs, and some minor soft tissue surgeries. It is particularly suitable for procedures that do not require general anesthesia but still necessitate adequate pain control and patient comfort.

One of the significant benefits of MAC sedation is that it allows the patient to avoid the potential risks and side effects associated with general anesthesia. General anesthesia involves using drugs that induce a state of complete unconsciousness, requiring the patient to be fully intubated and artificially ventilated. In contrast, MAC anesthesia provides a lighter level of sedation while preserving the patient's ability to breathe independently.

By using MAC anesthesia, the patient can avoid the potential complications associated with intubation, such as damage to teeth, vocal cords, or the trachea. Additionally, MAC reduces the risk of postoperative nausea and vomiting, which are common side effects of general anesthesia. This makes it an appealing option for patients who may be more susceptible to these adverse effects or prefer a lighter anesthesia experience.

Another advantage of MAC anesthesia in orthopedic procedures is its flexibility and adaptability. The anesthesia provider can adjust the level of sedation and pain control throughout the procedure, ensuring optimal comfort for the patient. This adaptability allows for better communication between the patient and the surgical team, as the patient can provide feedback regarding any discomfort or pain they may experience during the procedure. Monitored anesthesia care may also facilitate early recovery and faster discharge from the hospital or surgical facility.

How To Prepare for Monitored Anesthesia Care

To prepare for monitored anesthesia care, take the following steps:

1. Talk to your doctor about your medical history, medications, allergies, and if you are pregnant.

2. Avoid eating or drinking for the recommended time before the procedure to reduce the risk of problems during MAC
anesthesia.

3. Stop smoking and using nicotine products before the procedure.

4. Temporarily pause blood thinners, like aspirin, as instructed.

5. Arrange for someone to drive you home after the procedure because you may be sedated.

6. Get help at home for daily activities while you recover.

Following these steps will help ensure a safe and smooth experience during and after MAC anesthesia.

How Is Monitored Anesthesia Care Administered?

How Is Monitored Anesthesia Care Administered?

Monitored anesthesia care may be given to the patient through a needle or an IV. The amount of anesthesia delivered depends on the medical procedure. Some patients feel relaxed and groggy but are awake for the entire procedure and can respond to questions and commands. Other patients may fall into a light sleep, but they can be awakened during the procedure if needed. The anesthesia provider watches the patient's vital signs and adjusts the anesthesia to keep the patient safe and comfortable.

Are There Risks Associated With Monitored Anesthesia Care?

Like any medical procedure, there are inherent risks associated with monitored anesthesia care. It's important to understand that risks can be present in various types of procedures, including surgical, non-surgical, and minimally invasive interventions. While MAC sedation is generally considered safe, it is crucial to be aware of these potential risks:

  • Allergic reactions to anesthesia medications
  • Respiratory complications, such as breathing difficulties or airway obstruction
  • Changes in blood pressure or heart rate
  • Nausea and vomiting during or after the procedure
  • Headache or dizziness
  • Infection at the site of IV injection

It's important to note that the risks may vary depending on factors such as the patient's overall health, the specific procedure being performed, and more. Your anesthesia provider will discuss these risks with you and take necessary precautions to minimize them. They will closely monitor your vital signs and adjust anesthesia medications as needed to ensure your safety and comfort throughout the procedure.

Recovering From Monitored Anesthesia Care

After monitored anesthesia care, you will recover in a post-operative room with nurses ensuring your safety and comfort. The effects of sedation may last for several hours. If you had local or regional anesthesia, you may feel numb and have reduced muscle control. Pain and discomfort may occur as the anesthesia wears off, which is normal.

During the initial 24 hours following MAC anesthesia, it is important to refrain from engaging in tasks that require attention to detail. This includes activities like work, school, making important decisions, and signing legal documents. The effects of the anesthesia medications take time to fully wear off, and it is crucial to prioritize your safety. It is essential not to drive or operate machinery that could pose a risk until the anesthesia has completely cleared from your system, and you can think clearly and react promptly.

If you want to learn more about our monitored anesthesia care options, contact the expert physicians at Resurgens Orthopaedics. Book an appointment at one of our 24 Metro Atlanta locations today!

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