Monitored anaesthesia care (MAC) provides sedation for a procedure without general anaesthesia. The CRITICAL distinction between 'deep sedation' and 'general anaesthesia' in MAC is:

• A General anaesthesia requires endotracheal intubation; deep sedation does not
• B General anaesthesia uses only inhalational agents; deep sedation uses only IV drugs
• C Deep sedation is only achievable in specialised centres unlike general anaesthesia
• D In general anaesthesia, patients cannot be aroused even with painful stimuli; in deep sedation, purposeful response to pain is preserved ✓

Explanation

The ASA continuum of sedation defines: minimal sedation (anxiolysis) → moderate sedation (conscious sedation) → deep sedation → general anaesthesia. The key distinction between deep sedation and general anaesthesia is that in deep sedation, patients can be aroused with repeated or painful stimulation and maintain spontaneous ventilation, while in general anaesthesia, patients cannot be aroused even by painful stimuli and often require airway support. This distinction drives the level of monitoring and provider qualifications required. Any sedation can inadvertently progress to general anaesthesia, hence the same level of preparedness is required.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.