Monitored Anesthesia Care/Sedation

Question 1

What are the monitoring standards for MAC cases?

Answer 1

According to the standards set forth by the ASA, the patient’s
oxygenation, ventilation, and circulation shall be continually
monitored. This includes pulse oximetry, ECG, and blood
pressure (which must be assessed at least every five minutes).
During monitored anesthesia care cases, capnography is not
required, but ventilation must be assessed, at least, by
continual observation of qualitative clinical signs (e.g. chest rise
and breath sounds). The temperature is to be monitored any
time clinically significant changes in body temperature are
intended or anticipated.
ASA. Standards for Basic Anesthetic Monitoring. [Online] April
5, 2011.

Question 2

What is the definition of deep sedation?

Answer 2

Deep sedation is a drug-induced state where the patient cannot
be easily aroused, but responds purposefully to painful stimuli.
Ventilatory function may be impaired and the patient may
require assistance in maintaining a patent airway.
Cardiovascular function is usually unaffected.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1261.

Question 3

What is the definition of minimal sedation?

Answer 3

Minimal sedation, also known as anxiolysis, is a drug-induced
state where the patient’s cognitive function may be impaired,
but he/she can still respond verbally and ventilatory and
cardiovascular function is unchanged.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1261.