Types of Anesthesia
First review the ASA’s CONTINUUM OF DEPTH OF SEDATION, DEFINITION OF GENERAL ANESTHESIA ANDLEVELS OF SEDATION/ANALGESIA. This document put out by the ASA is an excellent document for reference when deciphering the different levels of sedation.
Here the patient responds normally to verbal commands. As the cognitive function and coordination may be impaired, the airway and cardiovascular functions are unaffected.
Monitored Anesthesia Care
As always, first refer to the ASA, DISTINGUISHING MONITORED ANESTHESIA CARE (MAC) FROM MODERATE SEDATION/ANALGESIA (CONSCIOUS SEDATION). With MAC, the anesthetist must assess and manage the patient’s actual or anticipated physiological disturbances or medical problems that may occur during the diagnostic or therapeutic procedure. The anesthetist must be prepared and qualified to convert to general anesthesia. The anesthetist’s ability to intervene to rescue the patient’s airway from any sedation induced cooperation is also vital. Keep in mind that although it may by MAC, the administration of sedatives, hypnotics, analgesics an/or anesthetic drugs may also be used for induction and maintenance of general anesthesia may be part of the procedure. Even small doses of medication can cause an adverse physiological response requiring the anesthetist’s intervention an resuscitation.
Moderate Sedation (Conscious Sedation)
Once again refer to the ASA, DISTINGUISHING MONITORED ANESTHESIA CARE (MAC) FROM MODERATE SEDATION/ANALGESIA (CONSCIOUS SEDATION). Here the patient is drug induced to depress consciousness but the patient responds purposefully to verbal commands alone or by light tactile stimulation. A difference between MAC and Moderate or Conscious Sedation is the maintenance of the cardiovascular function. To gain an even better understanding of the definition of Conscious Sedation, refer to the descriptions of a few common of the common drugs used to accomplish this state.
Here the patient is drug induced causing a depression of consciousness but the patient can respond to purposefully to only repeated or painful stimulation. The ability to maintain ventilatory function may be impaired and maintenance of the airway may be required. Cardiovascular maintenance as with Moderate Sedation is usually required.