MAC Anesthesia

Question 1

Unarousable patient to painful stimulus

Answer 1

Under general anesthesia

Question 2

patient under MAC appears as

Answer 2

not completely asleep, not intubated

Question 3

Monitoring required for MAC

Answer 3

Standard ASA monitors “should” be employed

ECG, NBP, O2, temp

Question 4

Preferred Pharmacological agents characteristics in MAC

Answer 4

rapid onset, short DOA

Question 5

Preferred Rx (MAC)

Answer 5

Midazolam
Propofol
Opioids (Remifentanil/Fentanyl)
Dex
Ketamine

Question 6

Preop eval (MAC) includes

Answer 6

1. medical status (Increased risk: morbid obesity, >70y/o, CVS/Renal/Hepatic dx, ASA III-IV)
2. airway (assess, aspiration risk)
3. appropriateness (able to move, cooperate, communicate)

Question 7

Minimal/no pain procedure - DOC

Answer 7

Midaz bolus + supplement PRN

*if morbid obesity, chronic pain, anxiety, OSA– Dex or Ketamine

Question 8

Brief, initial pain (nerve/eye block, diagnostic) - DOC

Answer 8

Larger doses -- hypnotic or analgesic
Midazolam 1-2mg IV
plus one of following:
fent 50-100mcg 
prop .5-1mg/kg 
remifent .5-1 mcg/kg

Question 9

Variable pain throughout procedure - DOC

Answer 9

infusions or repeated boluses