Moderate Sedation

(Conscious Sedation; Monitored Anesthesia Care; MAC; Sedation, Conscious; Sedation, Moderate)

Definition

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. Breathing support will not be needed. It will also be easy to wake you, so you can answer questions or move during surgery.

Reasons for Procedure

Moderate sedation can be used for a range of procedures. It may be used instead of general anesthesia if overall health is poor. Other benefits may include:

  • Faster recovery time
  • Fewer problems from anesthesia

A ventilator will also not be needed for moderate sedation.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems, like:

  • Nausea and vomiting
  • Headache
  • Temporary memory problems—you may not remember the surgery
  • Breathing problems during the surgery

Factors that may increase the risk of problems include:

  • Smoking
  • Advanced age
  • Obesity
  • Poor overall health, such as heart disease

What to Expect

Prior to Procedure

You will meet with a specialist before the surgery. They will ask about:

  • Past health
  • Any reactions to anesthetics
  • Medicine, herbs, or supplements you are taking

Food and drink may need to be stopped 8 to 12 hours before the surgery.

Description of Procedure

An IV will be placed in the arm. The sedation drugs and other medicine will be given through the IV.

Medications Delivered Through an IV

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The care team will monitor vital signs and comfort. Medicine may need to be adjusted through surgery. The goal will be to make sure you are comfortable and pain-free. The medicine may need to be increased so that you are fully asleep. Breathing support with a ventilator will then be needed.

Immediately After Procedure

The hospital staff will monitor vital signs.

How Much Will It Hurt?

The medicine will block pain during the procedure.

Average Hospital Stay

The length of your stay will depend on the reason you had surgery.

Post-procedure Care

The medicine will affect how you think or move even after you wake. Skilled things like driving should be avoided for the day.

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • 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
  • Lightheadedness

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Association of Nurse Anesthetists
http://www.aana.com

American Society of Anesthesiologists
http://www.asahq.org

CANADIAN RESOURCES:

Canadian Anesthesiologists' Society
http://www.cas.ca

Health Canada
https://www. canada.ca

REFERENCES:

Bayman E, Dexter F, Laur JJ, Wachtel RE. National incidence of use of monitored anesthesia care. Anesth Analg. 2011;113(1):165-169.

Furstein J, Patel M, Sadhasivasa S, Mahmoud M. Use of dexmedetomidine for monitored anesthesia care for diskography in adolescents. AANA Journal. 2011;79(5):421-425.

Moderate (conscious) sedation FAQ. American College of Emergency Physicians website. Available at: https://www.acep.org/content.aspx?id=30480#sm.0001fpfenu1dere2buhdwbfpp4x8i. Updated May 26, 2015. Accessed February 13, 2020.

Monitored anesthesia care. Northeastern Anesthesia Services website. Available at: https://www.northeasternanesthesia.com/youranasthesia/care.php. Accessed February 13, 2020.

Patient education brochures. American Society of Anesthesiologists website. Available at: http://www.asahq.org/resources/patients/patient-education-brochures. Accessed February 13, 2020.

Thompson K. Chapter 47: Monitored anesthesia care. University of North Carolina at Chapel Hill website. Available at: http://www.unc.edu/~rvp/old/RP_Anesthesia/Barash/Ch47_MAC.html. Accessed February 13, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 2/13/2020