Monitored Anesthesia Care

Abstract

Monitored anesthesia care (MAC) is a term used to describe an anesthetic that is not a general anesthetic, although it is important to remember that all anesthesia provided by an anesthesiologist is carefully monitored from the preoperative to intraoperative to postoperative period. MAC is best paired with some type of nerve blockade, whether that is local anesthetic infiltration, a peripheral nerve block, or a neuraxial block such as an epidural or spinal. MAC is additionally typically paired with some form of IV sedation, but this is not a requirement. It is important to remember when performing MAC that it is a spectrum from mild to moderate (i.e., conscious) to deep sedation. As the degree of sedation progresses, there is an increasing risk of hypotension and, perhaps more importantly, an increasing degree of upper airway obstruction, hypoventilation, and eventually apnea.