TY  - CHAP
M1  - Book, Section
TI  - Chapter 69. Monitored Anesthesia Care and Anesthesia Outside the Operating Room
A1  - Abdelmalak, Basem
A1  - Riad, Ihab
A2  - Longnecker, David E.
A2  - Brown, David L.
A2  - Newman, Mark F.
A2  - Zapol, Warren M.
Y1  - 2012
N1  - 
T2  - Anesthesiology, 2e
AB  - Many  patients  who  are  scheduled  for  monitored  anesthesia  care  (MAC)  are  considered  high  risk  for  general  anesthesia,  and  MAC  is  mistakenly  presumed  to  be  safer  than  general  anesthesia.MAC  does  not  describe  the  continuum  of  depth  of  sedation;  rather,  it  describes  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.Many  patients  who  are  considered  for  minimally  invasive  procedures  out  of  the  operating  room  (OR)  are  considered  high  risk  for  traditional  surgical  procedures.For  deep  sedation/MAC,  proper  choice  of  sedatives  and  their  dosing  can  optimize  patient  safety,  recovery,  and  discharge  times.The  same  monitoring  and  equipment,  preprocedure  evaluation,  NPO  (nothing  by  mouth)  status,  and  recovery  room  standards  used  in  the  OR  apply  to  remote  locations.The  length  and  type  of  procedure,  airway  considerations,  and  remoteness  of  the  location  should  all  be  considered  when  choosing  the  anesthetic  technique.Patient  safety  should  supersede  any  other  considerations  in  remote  location  anesthesia.Open  communication  between  the  anesthesiologist  and  the  proceduralist  is  key  to  safety  and  favorable  outcomes.Propofol  sedation  is  classified  as  deep  sedation  in  many  circumstances.  It  may  result  in  significant  changes  in  airway  anatomy  and  cardiopulmonary  physiology.  Therefore,  propofol  should  be  administered  only  by  clinicians  qualified  to  rescue  patients  from  any  level  of  sedation,  including  general  anesthesia.Involvement  of  the  anesthesiologists  in  institutional  sedation  policy  and  in  planning  and  developing  remote  anesthesia  locations  is  essential.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=56650311
ER  -