Sri Lankan Journal of Anaesthesiology 16(2) : 104 – 107 (2008) MONITORED ANAESTHESIA CARE

Key words: monitored anaesthesia care; pharmacology Monitored Anaesthesia Care (MAC) refers to a clinical service wherein an anaesthesiologist provides analgesia and sedation for a diagnostic or therapeutic procedure, and the patient is able to protect his airway for the majority of the procedure. 1 It involves the administration of medication that can potentially lead to loss of consciousness and normal protective reflexes. There is possibility of a deeper plane of sedation compared to ‘sedation/analgesia ’ which is provided by a non-anaesthesiologist. 2 Therefore, the ASA recommends that the standards of care be same as for general or regional anaesthesia, with regard to pre-operative evaluation, intra-operative monitoring of the cardio-respiratory system, the physical presence of an anaesthesiologist at all time, and the administration of oxygen and other medications to keep the patient safe and comfortable. 1 MAC should invoke less physiological disturbance and allow a more rapid recovery compared to a general anaesthetic. Therefore, it is not surprising to note that it is the technique of choice in up to 30 % of the surgical procedures. The three essential components of MAC are – safe sedation, anxiolysis and analgesia. 3 However, patient comfort, cardio-respiratory stability, good operating conditions and minimal side effects are equally important. Preoperative assessment The preoperative evaluation (history, examination and review of investigations) and optimization should be as for a general or regional anaesthetic. However, there are certain factors unique fo