Monitored anesthesia care: An overview

Das, Suman; Ghosh, Santanu

doi:10.4103/0970-9185.150525

Cited by 55 publications

(49 citation statements)

References 15 publications

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“…Monitoring anesthesia depth is essential for providing optimal anesthesia as it enables the maintenance of adequate anesthesia level. (1) The bispectral index (BIS) monitor can reduce the risk of intraoperative awareness as well as facilitate faster recovery after general anesthesia by enabling the anesthesiologists to appropriately adjust the anesthetic dose. (2,3) Recently, there has been a growing interest in how the depth of anesthesia monitored using BIS affects postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

Yoon

Yoo

Hur

et al. 2020

Preprint

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Background The influence of intraoperative low bispectral index (BIS) values and hypotension on poor clinical outcomes has been controversial. The purpose of this study was to investigate the influence of intraoperative low BIS values and hypotension on postoperative mortality in patients undergoing major abdominal surgery. Methods This retrospective study analyzed 1,862 cases of general anesthesia. We collected the cumulative time of BIS values below 20 and 40 as well as electroencephalographic suppression and documented the incidences in which these states were maintained for at least 5 minutes. Durations of intraoperative mean arterial pressures (MAP) less than 50 mmHg were also recorded. Multivariable logistic regression was used to evaluate the association between suspected risk factors and postoperative mortality. Results Ninety-day mortality and 180-day mortality were 1.5% and 3.2% respectively. The cumulative time in minutes for BIS values falling below 40 coupled with MAP falling below 50 mmHg was associated with 90-day mortality (odds ratio, 1.26; 95% confidence interval, 1.04-1.53; P = .019). We found no association between BIS related values and 180-day mortality. Conclusions Delicate adjustment of anesthetic depth is important to avoid excessive brain suppression and hypotension, which could be associated with postoperative mortality.

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Section: Introductionmentioning

confidence: 99%

The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

Yoon

Yoo

Hur

et al. 2020

Preprint

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“…According to American Society of Anaesthesiologists, monitored anaesthesia care (MAC) is a specific anaesthesia service for diagnostic and therapeutic procedures performed under local anaesthesia along with sedation and analgesia titrated to a level that preserves spontaneous breathing and airway reflexes. 1 The three basic components of MAC includes safe conscious sedation, measures to allay patient's anxiety and effective pain control. 2 MAC is essentially an anaesthesiologist led service with skill to rescue airway or convert to general anaesthesia if the need arises.…”

Section: Introductionmentioning

confidence: 99%

“…2 MAC is essentially an anaesthesiologist led service with skill to rescue airway or convert to general anaesthesia if the need arises. 1 This unique aspect of anaesthesia service distinguishes it from moderate sedation/ analgesia or conscious sedation. 3 Over the years, middle ear surgeries are being performed successfully under local anaesthesia with sedation.…”

Section: Introductionmentioning

confidence: 99%

Patient satisfaction in middle ear surgery under monitored anaesthesia care

Lama

Sigdel

Gurung

et al. 2019

Med. J. Pokhara Acad. Health Sci.

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Background: Monitored anaesthesia care is a specific anaesthesia service for diagnostic or therapeutic procedures performed under local anaesthesia along with sedation and analgesia titrated to a level with the provision to convert into general anaesthesia when required. We conducted a retrospective study to determine patient satisfaction in middle ear surgery under monitored anaesthesia care. Materials and Methods: The number of patients undergoing middle ear surgery under monitored anaesthesia care, over a period of one year were included. They received sedation with midazolam 0.02 mg/kg and fentanyl 1 mcg/kg along with local anaesthetic infiltration. Patient’s satisfaction was measured using a five point Likert scale. Intraoperative pain, nausea, vomiting and other discomforts were inquired. Results: The total number of patients was 64. Fifty-one patients (79.7%) were satisfied, 10 were neutral (15.6%) and 3 patients (4.7%) were dissatisfied with the technique. Earache (4.7%), followed by dizziness (3.1%) and bodyache (3.1%) were the most common cause of discomfort. Nausea occurred in 6 patients (9.4%) and vomiting in 5 patients (7.8%). Conclusion: Middle ear surgeries can be performed under monitored anaesthesia care with good patient satisfaction.

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“…This study investigates the effects of the monitored anaesthesia care inhalatory sedation using Sevoflurane versus intravenous sedation with Propofol added for spinal anaesthesia in young children. Monitored anesthesia care sedation in this case refers to a conscious sedation in connection with a regional anesthetic technique which allows the patient to preserve normal protective reflexes and concerns the monitoring of the cardiovascular functions [3].…”

mentioning

confidence: 99%

Effect of 2,6-diisopropylphenol and 1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy) propane as Anesthetic

Lupu¹,

Miulescu²,

Ștefanopol³

et al. 2019

Rev. Chim.

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Sevoflurane (2,2,2-trifluoro-1-[trifluoromethyl]ethyl fluoromethyl ether or C4H3F7O), with a molar mass 200.055 g/mol, also called fluoromethyl, is a highly fluorinated methyl isopropyl ether with general anesthetic property, available for clinical practice for about 30 years. Sevoflurane is a sweet-smelling, non-flammable and it is used for induction and maintenance of general anesthesia. Together with desflurane, it is replacing isoflurane and halothane in modern anesthesiology. Propofol (2,6-diisopropylphenol or C12H18O), with a molar mass 178.271g/mol is an alkylphenol derivative formulated for induction and maintenance (in some cases) of general anesthesia, sedation and hypnosis and acting as an intravenous anaesthetic drug, having largely replaced sodium thiopental because recovery from propofol is more rapid and clear.

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Monitored anesthesia care: An overview

Cited by 55 publications

References 15 publications

The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

Patient satisfaction in middle ear surgery under monitored anaesthesia care

Effect of 2,6-diisopropylphenol and 1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy) propane as Anesthetic

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