Monitored anesthesia care (MAC)

Monitored anesthesia care is a specific anesthesia service in which an anesthesiologist has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure. Monitored anesthesia care includes all aspects of anesthesia care including a pre-procedure teleheath screen , intra-procedure care and post-procedure anesthesia management.

During monitored anesthesia care, the anesthesiologist or a member of the anesthesia care team provides a number of specific services, including but not limited to:

• Monitoring of vital signs, maintenance of the patient's airway and continual evaluation of vital functions

• Diagnosis and treatment of clinical problems which occur during the procedure

• Administration of sedatives, analgesics, hypnotics, anesthetic agents or other medications as necessary to

ensure patient safety and comfort

• Provision of other medical services as needed to accomplish the safe completion of the procedure.

Monitored anesthesia care often includes the administration of doses of medications for which the loss of normal protective reflexes or loss of consciousness is likely. Monitored anesthesia

care refers to those clinical situations in which the patient remains able to protect the airway for the majority of the procedure.

Sedation/ IV Sedation is anesthesia where a drug is given to calm a patient during an otherwise excited, uncomfortable, or anxious period of time. Often administered to patients immediately prior to

surgery or during uncomfortable medical procedures.

One of the most important things you can do to keep yourself safe is to have a thorough preoperative discussion with a member of the anesthesia team .Your anesthesia team will be

calling you a few days prior to your procedure, please make sure to have a working number on file and to answer phone calls from 480-562-7232. It’s an opportunity to provide the anesthesiologist with information vital to your care and for you to express your wishes about anesthesia and postoperative pain control. Your medical history is important. Mention any adverse reactions to anesthesia in yourself or your parents, siblings, or children. Anesthesia reactions can run in families, and some hereditary disorders need special attention. Bring a list of all the prescription and over-the-counter medications you take. For example, aspirin and other NSAIDs can interfere with blood clotting and will need to be discontinued up to two weeks before surgery. Be sure to mention any supplements or herbal products you take. Several herbs can cause problems with bleeding or blood pressure during surgery or interact with anesthesia medications. Make note of any allergies. And be sure to report any loose teeth, dentures, or crowns; they could be damaged if a tube is placed into your throat to help you breathe. The preoperative interview is also a good time to learn what to expect when you wake up from surgery. For example, some anesthetics can produce nausea or headaches. It’s also wise to find out how long the effects of anesthesia may last. Depending on the type of anesthesia, you may be advised not to drink alcohol, drive a car, or operate any complex machinery for at least 24 hours following anesthesia.

Recovery from anesthesia takes a variable amount of time depending on the type of medications used, type and duration of surgery and the patient. You will awaken and recover from the anesthesia in a recovery room. Our staff will be with you to closely monitor your vital signs and overall condition. You will stay in this room until you have met criteria for discharge to your home. You will be drowsy and have mild confusion as you emerge from  anesthesia. If you have either pain or nausea, tell your anesthesia staff and medication will be administered until you are comfortable. You may feel drowsy or tired for a couple of hours or longer depending on your surgery. A sore throat occasionally is experienced after anesthesia, but should resolve within 24-48 hours.

The risk of anesthetic administration is determined by the patient’s health status, the nature of the surgical procedure and if the care is being provided electively or because of a surgical emergency. If you want to know more about the risk of anesthesia in your case, your anesthesiologist can make the best assessment during your pre-anesthetic evaluation. Anesthetic risk can be reduced by providing complete information about your health to your anesthesiologist and by carefully following our fasting (also called “NPO” or “nothing by mouth”) guidelines and instructions regarding any medication you are taking on a regular basis.

An appropriate fasting period prior to elective procedures performed during anesthesia is essential for patient safety. The objective is to empty the stomach so the risk of inhaling stomach contents into the lungs is reduced. This is a serious potential complication called pulmonary aspiration and in severe cases can be fatal. In emergencies, special precautions are taken but elective surgery will be cancelled if the fasting instructions are not followed.