RT Book, Section A1 Riad, Ihab A. A1 Abdelmalak, Basem A2 Longnecker, David E. A2 Mackey, Sean C. A2 Newman, Mark F. A2 Sandberg, Warren S. A2 Zapol, Warren M. SR Print(0) ID 1144133793 T1 Monitored Anesthesia Care and Non–Operating Room Anesthesia T2 Anesthesiology, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071848817 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144133793 RD 2024/11/04 AB KEY POINTSMany patients who are scheduled for monitored anesthesia care (MAC) are considered to be at 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 in non–operating room locations are considered to be at 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) guidelines, and recovery room standards used in the OR apply to non–operating room anesthesia (NORA).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 NORA.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 NORA locations is essential.