MAC的过去与现状——换名仅仅是因为麻醉技术的改进吗

History and current status of monitored anesthesia care(MAC)——Alteration of appellation only for improving in anesthetic technology?

从上世纪80年代中期到2005年,历经20多年,MAC的出炉和多次修正无不体现了社会进步、麻醉工作的艰辛和ASA的责任感和使命感。ASA的工作既规范了MAC的技术标准、为其准确定位,又为拒绝付费消除了障碍。当然,十几年来的临床实践同时也表明,如果管理不当,MAC期间同样可以引起死亡和永久性脑损害,给病人造成的损伤及其赔偿金额并不亚于其他麻醉方式。我们应当切记MAC所需的麻醉警示程度应达到顶点,而绝非是起点。

Over two decades, that is from middle of 1980s to 2005, the debut of MAC and it＇ s amendment embodied the social progress and the hardships of cause of anesthesiology and the ASA＇ s sense of duty and mission. ASA＇ s work have standardized the definition and position of MAC, and also dispelled the defence of denying payment for anesthesiologist sedation. Certainly, the clinical practice since 1990 indicates that MAC equally can lead to severe central nervous system injury and death without appropriate use of monitoring and vigilance, and the payment frequency and amounts were similar for all types of anesthesia. Mind that we don＇ t forget MAC should stand for maximum anesthesia caution, not minima/anesthesiology care.