Minimal Sedation (Anxiolysis)

• A drug-induced state during which patients respond normally to verbal commands.
• Cognitive function and coordination may be impaired.
• Ventilatory and cardiovascular functions are unaffected.

Moderate Sedation/ Analgesia ("Conscious Sedation")

• A drug-induced depression of consciousness during which
• patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation
• reflex withdrawal from a painful stimulus is NOT considered a purposeful response
• No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.
• Cardiovascular function is usually maintained.

Deep Sedation/ Analgesia

• A drug-induced depression of consciousness during which patients cannot be easily aroused, but
• respond purposefully following repeated or painful stimulation.
• reflex withdrawal from a painful stimulus is NOT considered a purposeful response
• The ability to independently maintain ventilatory function may be impaired.
• Patients may require assistance in maintaining a patent airway.
• Spontaneous ventilation may be inadequate.
• Cardiovascular function is usually maintained.

General Anesthesia

• A drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation.
• The ability to independently maintain ventilatory function is often impaired.
• Patients often require assistance in maintaining a patent airway.
• Positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function.
• Cardiovascular function may be impaired.

The Continuum of Sedation -- Anesthesia

• Because sedation is a continuum, it is not always possible to predict how an individual patient will respond.
• Practitioners intending to produce a given level of sedation should be able to rescue patients whose level of sedation becomes deeper than initially intended.
• Individuals administering Moderate Sedation/Analgesia ("Conscious Sedation") should be able to rescue patients who enter a state of Deep Sedation/Analgesia
• Those administering Deep Sedation/Analgesia should be able to rescue patients who enter a state of general anesthesia.

Monitored Anesthesia Care (MAC)

• Does not describe the continuum of depth of sedation.
• Rather, it describes "a specific anesthesia service in which an anesthesiologist has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure."