Monitored Anesthesia Care: Less Safe than You Think

Research on safety outcomes of monitored anesthesia care (MAC) is lacking. Only one small study of MAC provided by certified registered nurse anesthetists has been reported.

To document adverse outcomes of MAC, researchers retrospectively reviewed 17,999 endoscopic procedures performed during 8 years in a hospital in Italy. Patients received MAC in cases of increased anxiety or therapeutic difficulty of the procedure.

Complications during MAC occurred in 792 patients (4.5%). Hypotension, which necessitated intervention, occurred in 312 patients (1.8%) and involved intravenous (IV) fluids or colloid in all patients; 22% received pharmacologic support with IV ethylephrine. Aspiration occurred in 18 patients (0.1%). The severity of these events …