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Conscious sedation and monitored anesthesia care (MAC) refer to an awareness somewhere in the middle of the spectrum, depending on the degree to which a patient is sedated. Monitored anesthesia care involves titration of local anesthesia along with sedation and analgesia. [18] Awareness/wakefulness does not necessarily imply pain or discomfort.
This level, called moderate sedation/analgesia or conscious sedation, causes a drug induced depression of consciousness during which the patient responds purposefully to verbal commands, either alone or accompanied with light physical stimulation. Breathing tubes are not required for this type of anesthesia. This is twilight anesthesia. [2]
It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.
Minimal sedation – normal response to verbal stimuli. Moderate sedation – purposeful response to verbal/tactile stimulation. (This is usually referred to as "conscious sedation") Deep sedation – purposeful response to repeated or painful stimulation. General anesthesia – unarousable even with painful stimulus.
Certain procedures, such as endoscopies or colonoscopies, are managed a technique called conscious sedation or monitored anesthesia care. These cases are performed with regional anesthetics and a "twilight sleep" achieved through sedation with propofol and analgesics, and patients may remember perioperative events. [4]
It is safe to perform sedation in the emergency room on patients who are ASA 1 or 2. If the patient is ASA 3 or 4 additional resources might be needed, such as a person with more training in procedural sedation, an anesthesiologist. [1] Furthermore, before a qualified anesthesia professional performs PSA, an Informed consent should be completed ...
General anaesthesia (UK) or general anesthesia (US) is a method of medically inducing loss of consciousness that renders a patient unarousable even with painful stimuli. [5] This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and ...
To determine the depth of anesthesia, the anesthetist relies on a series of physical signs of the patient. In 1847, John Snow (1813–1858) [1] and Francis Plomley [2] attempted to describe various stages of general anesthesia, but Guedel in 1937 described a detailed system which was generally accepted. [3] [4] [5]
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