(Conscious Sedation; Monitored Anesthesia Care; MAC; Sedation, Conscious; Sedation, Moderate)
Moderate sedation is used during surgery. It will put you in a comfortable, sleepy, and pain-free state. Moderate sedation is different from general anesthesia because it does not require breathing support. It will also be easy to arouse you, so you can respond to questions or commands during surgery.
Reasons for Procedure
Moderate sedation can be used for a range of procedures. If your overall health is poor, your doctor may recommend this type of sedation instead of general anesthesia.
The potential benefits include:
- Faster recovery time
- Fewer complications
Also, moderate sedation does not require you to be connected to a ventilator.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Nausea and vomiting
- Temporary memory problems—you may be unable to recall the surgery
- Breathing problems during the surgery
Factors that may increase the risk of problems include:
- Advanced age
- Poor overall health, such as cardiovascular disease
What to Expect
Prior to Procedure
You will meet with an anesthesiologist who will evaluate you and ask about:
- Your medical history, including any previous reaction to anesthetics
- Medications, herbs, or supplements you are taking
You may be instructed to:
- Avoid eating and drinking 8-12 hours before the surgery
- Take an anesthetic the morning of the surgery
Description of Procedure
The anesthetic drugs and other medications will be delivered by an IV in your arm. The doctor may also use local anesthesia at the surgery site.
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You will be carefully monitored during the surgery. Your medications may need to be adjusted to keep a certain level of sedation. The goal will be to make sure you are comfortable and pain-free.
Your sedation may be increased so that you are fully asleep. If this is the case, a ventilator will be used to support your breathing.
Immediately After Procedure
The hospital staff will monitor your vital signs.
How Much Will It Hurt?
You will not have any pain during the surgery.
Average Hospital Stay
The length of your stay will depend on the reason you had surgery. You may be able to go home the same day as the procedure. However, you may need to stay a few nights.
If you are discharged on the same day as the surgery, do not drive or operate machinery. The medications can affect your mental and physical abilities.
Call Your Doctor
Call your doctor if any of these occur:
- Signs of infection, such as fever and chills
- Nausea and vomiting
- Pain that cannot be controlled with the medications you were given
- Cough, shortness of breath, or chest pain
If you think you have an emergency, call for medical help right away.
American Association of Nurse Anesthetists
American Society of Anesthesiologists
Canadian Anesthesiologists' Society
American Society of Anesthesiologists. Distinguishing monitored anesthesia care (MAC) from moderate sedation/analgesia (conscious sedation). 2009;Oct 21.
Bayman E, Dexter F, et al. National incidence of use of monitored anesthesia care.
Anesth Analg. 2011;113(1):165-169.
Furstein J, Patel M, et al. Use of dexmedetomidine for monitored anesthesia care for diskography in adolescents.
AANA Journal. 2011;79(5):421-425.
Ghisi D, Fanelli A, et al. Monitored anesthesia care.
Minerva Anestesiol. 2005;71(9):533-538.
Moderate (conscious) sedation FAQ. American College of Emergency Physicians website. Available at: http://www.acep.org/content.aspx?id=30480. Updated June 2014. Accessed August 20, 2014.
Monitored anesthesia care. Northeastern Anesthesia Services website. Available at:
http://www.northeasternanesthesia.com/youranasthesia/care.php. Accessed August 20, 2014.
Thompson K. Chapter 47: Monitored anesthesia care. University of North Carolina at Chapel Hill website. Available at:
http://www.unc.edu/~rvp/old/RP%5FAnesthesia/Barash/Ch47%5FMAC.html. Accessed August 20, 2014.