Monitored Anesthesia Care (MAC)

September 10, 2024 2:48 PM

I am having surgery soon under Monitored Anesthesia Care. When I was in the emergency room for the initial injury, they had to do a nerve block multiple times because it wasn't taking in the first place and then I was metabolizing it so fast and it was excruciatingly painful. My questions: Will I be aware if this is happening, but just won't remember it afterward? And if I'm not aware, then how will they know if the nerve block is not effective or is losing effectiveness? I did have shoulder surgery a few years ago and I remember my dead hand slowly coming to life many hours later so I assume a nerve block can be effective for me. Is the nerve block in the ER different?
posted by HotToddy to Health & Fitness (3 answers total)

This page summarizing MAC from the American society of Anesthesiologists seems to be a good resource.

It says MAC allows for deeper sedation that moderate anesthesia, all the way up to general anesthesia, as needed for your safety and comfort. The level you receive will depend on your needs during the procedure.

You may or may not have awareness of the procedure, but the anesthesiologist should be able to monitor whether you are experiencing pain even if you are non-communicative.
posted by zippy at 3:11 PM on September 10

I would definitely talk with the anesthesiologist about this - beforehand if you can set up a meeting or send them a message, but definitely when they meet with you immediately prior to the procedure. A relative of mine has had similar things happen and they are only all too happy to accommodate individual differences if they are aware of them. It helped a lot when a previous incident had happened at the same facility so that they had good documentation and knew the other doctors involved - for some reason they always seem to just kind of smile and nod at whatever the patient tells them, without that kind of specific information . . .

FWIW different specific formulations of the anesthetic, or a different medication or medication type, will work differently. You might have a different type and have no problems at all. That's one reason it's helpful if you can get the anesthesiologist aware of the situation ahead of time. This is the exact type of thing they are expert in. Just for example, if you know the exact type of nerve block used before, that didn't work, that would be helpful information for future similar situations. The information might be in the records of your previous procedure (available via online medical records system?0 or they might be able to dig up that specific information for you if request it from them.
posted by flug at 4:10 PM on September 10 [1 favorite]

Response by poster: Okay thanks, I set up a call with the surgeon for later today to discuss this and I'll try to get the info from the ER.
posted by HotToddy at 7:44 AM on September 12