The Effect of MAC (Monitored Anesthesia Care) on Perioperative Pain in Endoscopic Sinus Surgery

Choi, Hyun Seung; Kim, Hyun Jik; Baek, Seung Jae; Kim, Kyu Bo; Kim, Jin Young; Gil, Hye Geum; Lee, Jeung Gweon

Abstract

BACKGROUND AND OBJECTIVES: Pain and anxiety control is the most important factor for patients that have undergone endoscopic sinus surgery under local anesthesia. Monitored anesthesia care (MAC) technique has been applied to local anesthetic patients for anxiolysis and analgesia. This technique encompasses the use of sedatives, tranquilizers and analgesics in combination to local supplements. This study was performed to evaluate the effectiveness of MAC for intraoperative pain control in patients who have undergone endoscopic sinus surgery.
MATERIALS AND METHODS
We studied 83 patients undergoing ambulatory endoscopic sinus surgery. Patients were randomly allocated into 2 groups of MAC (n=49) and placebo (n=34). We administrated alfentani1 and propofol intravenously at 2-3 minutes before local anesthesia for endoscopic sinus surgery. We evaluated the intraoperative pain with visual analogue pain score (VAS) and satisfactory score to pain control.
RESULTS
Overall, MAC cases showed statistically significant better VAS than placebo cases. Satisfactory score to pain control was also higher in MAC cases than placebo cases.
CONCLUSION
We conclude that MAC is an effective method using intravenous sedatives and analgesics for intraoperative sedation and pain control in patients undergoing endoscopic sinus surgery under local anesthesia.