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Moderate Sedation

(Conscious Sedation; Monitored Anesthesia Care; MAC; Sedation, Conscious; Sedation, Moderate)

Definition

Moderate sedation is used during surgery. It will put you in a comfortable, sleepy, and pain-free state. Moderate sedation is different from general anesthesia because it does not require breathing support. It will also be easy to arouse you, so you can respond to questions or commands during surgery.

Reasons for Procedure

Moderate sedation can be used for a range of procedures. If your overall health is poor, your doctor may recommend this type of sedation instead of general anesthesia.
The potential benefits include:
Also, moderate sedation does not require you to be connected to a ventilator.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Factors that may increase the risk of problems include:

What to Expect

Prior to Procedure

You will meet with an anesthesiologist who will evaluate you and ask about:
  • Your medical history, including any previous reaction to anesthetics
  • Medications, herbs, or supplements you are taking
You may be instructed to:
  • Avoid eating and drinking 8-12 hours before the surgery
  • Take an anesthetic the morning of the surgery

Description of Procedure

The anesthetic drugs and other medications will be delivered by an IV in your arm. The doctor may also use local anesthesia at the surgery site.
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You will be carefully monitored during the surgery. Your medications may need to be adjusted to keep a certain level of sedation. The goal will be to make sure you are comfortable and pain-free.
Your sedation may be increased so that you are fully asleep. If this is the case, a ventilator will be used to support your breathing.

Immediately After Procedure

The hospital staff will monitor your vital signs.

How Much Will It Hurt?

You will not have any pain during the surgery.

Average Hospital Stay

The length of your stay will depend on the reason you had surgery. You may be able to go home the same day as the procedure. However, you may need to stay a few nights.

Post-procedure Care

If you are discharged on the same day as the surgery, do not drive or operate machinery. The medications can affect your mental and physical abilities.

Call Your Doctor

Call your doctor if any of these occur:
If you think you have an emergency, call for medical help right away.

RESOURCES

American Association of Nurse Anesthetists http://www.aana.com

American Society of Anesthesiologists http://www.asahq.org

CANADIAN RESOURCES

Canadian Anesthesiologists' Society http://www.cas.ca

Health Canada http://www.hc-sc.gc.ca

References

American Society of Anesthesiologists. Distinguishing monitored anesthesia care (MAC) from moderate sedation/analgesia (conscious sedation). 2009;Oct 21.

Bayman E, Dexter F, et al. National incidence of use of monitored anesthesia care. Anesth Analg. 2011;113(1):165-169.

Furstein J, Patel M, et al. Use of dexmedetomidine for monitored anesthesia care for diskography in adolescents. AANA Journal. 2011;79(5):421-425.

Ghisi D, Fanelli A, et al. Monitored anesthesia care. Minerva Anestesiol. 2005;71(9):533-538.

Moderate (conscious) sedation FAQ. American College of Emergency Physicians website. Available at: http://www.acep.org/content.aspx?id=30480. Updated June 2014. Accessed August 20, 2014.

Monitored anesthesia care. Northeastern Anesthesia Services website. Available at: http://www.northeasternanesthesia.com/youranasthesia/care.php. Accessed August 20, 2014.

Thompson K. Chapter 47: Monitored anesthesia care. University of North Carolina at Chapel Hill website. Available at: http://www.unc.edu/~rvp/old/RP%5FAnesthesia/Barash/Ch47%5FMAC.html. Accessed August 20, 2014.

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