Department of Anesthesia, University of Iowa, Anesthesia 6JCP, Iowa City, Iowa 52242, USA.
Anesth Analg. 2011 Jul;113(1):165-9. doi: 10.1213/ANE.0b013e31821c3e8e. Epub 2011 May 19.
Sedation or monitored anesthesia care (MAC), alone or after peripheral regional nerve block, is currently administered by anesthesiologists and/or certified registered nurse anesthetists. Some of this care may be at risk for substitution by other providers or by reductions in reimbursement.
Data from the 2006 United States of America National Survey of Ambulatory Surgery were analyzed to determine national rates for the percentage of total ambulatory anesthesia operating room (OR) time that was either (1) sedation and/or MAC, or (2) peripheral regional nerve block with/without sedation or MAC.
MAC cases alone comprised 29%± 2% of OR time with an anesthesiologist and/or certified registered nurse anesthetist. MAC and/or peripheral block comprised 34% ± 2% of OR time. Percentages by cases were larger than by OR time (P < 0.0001). Among cases with anesthesia, 42% ± 3% were MAC and 47% ± 2% were MAC with/without peripheral block. Percentages of American Society of Anesthesiologists' Relative Value Guide units for MAC would be intermediate between the 29% and 42%, and for MAC and/or peripheral block between the 34% and 47%.
MAC alone or after peripheral nerve block accounts for a relatively high percentage of ambulatory anesthetics nationwide.
镇静或监测麻醉管理（MAC），单独使用或在周围区域神经阻滞之后，目前由麻醉师和/或注册护士麻醉师管理。其中一些护理可能面临被其他提供者替代或报销减少的风险。
分析了 2006 年美国全国门诊手术调查的数据，以确定总门诊麻醉手术室（OR）时间中，（1）镇静和/或 MAC，或（2）周围区域神经阻滞加/不加镇静或 MAC 的百分比，分别占全国比率。
MAC 单独占 OR 时间的 29%±2%，有麻醉师和/或注册护士麻醉师参与。MAC 和/或周围阻滞占 OR 时间的 34%±2%。按病例计算的百分比大于按 OR 时间计算的百分比（P<0.0001）。在接受麻醉的病例中，42%±3%为 MAC，47%±2%为 MAC 加/不加周围阻滞。MAC 的美国麻醉医师协会相对价值指南单位百分比介于 29%和 42%之间，MAC 和/或周围阻滞的百分比介于 34%和 47%之间。
单独使用 MAC 或在周围神经阻滞之后，占全国门诊麻醉的相对较高比例。
