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Chapter 18 - Monitored Anesthesia Care and Sedation

Published online by Cambridge University Press:  21 February 2025

By
Ethan O. Bryson
Edited by
Dharti Patel ,
Sang J. Kim ,
Himani V. Bhatt  and
Alopi M. Patel
Dharti Patel
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Sang J. Kim
Affiliation:
Hospital for Special Surgery, New York
Himani V. Bhatt
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Alopi M. Patel
Affiliation:
Rutgers Robert Wood Johnson Medical School, New Jersey
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Summary

Monitored anesthesia care (MAC) is a varying type of anesthesia where an anesthesiologist is involved in a patient’s care ranging from either fully awake with ASA monitoring or a deeper level of sedation with a natural airway depending on the level of surgical stimulus and the patient’s physiological state. This chapter discusses the different levels of sedation, ASA guidelines for sedation, and associated risks and complications.

Keywords

MACsedationnatural airwaymidazolam
Type
Chapter
Information
BASIC Essentials
A Comprehensive Review for the Anesthesiology BASIC Exam
 , pp. 101 - 102
Publisher: Cambridge University Press
Print publication year: 2025

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References

American Society of Anesthesiologists Committee of Origin: Quality Management and Departmental Administration. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia. (Approved by the ASA House of Delegates on October 13, 1999, and last amended on October 15, 2014).Google Scholar
American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists: an updated report. Anesthesiology 2002; 96:1004–1017.CrossRefGoogle Scholar
American Dental Association. Guidelines for the use of general anesthesia and sedation by dentists. Adopted by the ADA house of delegates October 2016.Google Scholar
Das, S, Ghosh, S. Monitored anesthesia care: an overview. J Anaesthesiol Clin Pharmacol 2015;31(1):27–29.CrossRefGoogle ScholarPubMed
Bhananker, SM, Posner, KL, Cheney, FW, et al. Injury and liability associated with monitored anesthesia care: a closed claims analysis. Anesthesiology 2006;104(2):228–234.CrossRefGoogle Scholar
Agostoni, M, Fanti, L, Gemma, M, et al. Adverse events during monitored anesthesia care for GI endoscopy: an 8-year experience. Gastrointest Endosc 2011;74(2):266–275.CrossRefGoogle ScholarPubMed

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