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anesthesia quick
glossary
what is anesthesia?
who administers anesthesia?
who gets what type
of anesthesia?
local anesthesia:
topical, cold, cream
local anesthesia:
injection, tumescent, ring block, regional block
IV sedation / monitored anesthesia care
general anesthesia
stages of general
anesthesia
preparing for anesthesia
anesthesia and herbal
drug interactions
anesthesia and prescription
drug interactions
post-anesthesia
guidelines
anesthesia fees
Types of Anesthesia
IV SEDATION / MONITORED ANESTHESIA CARE
Monitored Anesthesia Care (MAC), also known as IV Sedation
or Twilight Anesthesia, is a safe and effective method
of anesthesia for procedures requiring relaxation but
not unconsciousness. During the procedure, the anesthesia
specialist delivers varying amounts of sedating and
anesthetic medication through an intravenous (IV) line,
monitoring the patient's comfort level and increasing
or decreasing medication as needed (hence the name monitored
anesthesia care).
Your vital signs and other bodily reactions are monitored
with a blood pressure cuff, heart rate monitor, pulse
oximeter (that measures the level of oxygen in the blood),
and an EKG machine. MAC is typically combined with injection
of local anesthetic at the surgical site for additional
pain control and to minimize bleeding. (Local anesthesia
can also be used before the IV is inserted to reduce
the discomfort felt as the IV is positioned).
IV sedation is a good middle ground between local anesthesia
(where the patient is awake) and general anesthesia
(where the patient is asleep). It is sometimes preferred
to general anesthesia because patients recover more
quickly with less nausea and vomiting. Additionally,
unlike general anesthesia, the dosage of the twilight
anesthesia can be lightened to a level that allows the
patient to respond to verbal commands and move with
assistance. This is especially beneficial when the surgeon
wants to see what the operative area would look like
in a sitting or standing position, or with contraction
of particular muscles: a technique commonly used with
liposuction, breast surgery, and facelift surgery.
IV medications commonly employed with MAC include Versed,
Fentanyl, Propofol, and sometimes Ketamine. Versed is
frequently used before surgery to calm the patient before
entering the operating room. It relaxes the patient
and causes temporary amnesia, blocking memory of the
first few minutes after injection.
Fentanyl works as a strong narcotic pain medication.
In addition to blocking pain perception, narcotics also
lower blood pressure and heart rate, which can be helpful
in counteracting normal responses to pain that occur
during surgery. Similar, newer drugs (Sufentanil, Alfentanil,
and Remifentanil) and the old favorites, Morphine and
Demerol are other long lasting narcotic pain medications
that can be administered through the IV. All narcotics
can cause nausea and vomiting.
Propofol (also known as Diprivan) is a popular medication
that can yield moderate to heavy sedation without the
problems of disorientation afterwards. Once the infusion
is turned off, the patient will be awake within 5 minutes.
Ketamine is sometimes given when the local anesthetic
is injected because it temporarily makes the patient
unaware of his surroundings. (Extreme care must be taken
with Ketamine as serious side effects such as heart
rate disturbances and hallucinations can occur). A few
doctors are using a relatively new anesthesia technique
called PK, combining Propofol with Ketamine as the mainstays
of anesthesia.
To Next Section
- General Anesthesia
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