What does MAC really mean in layman's terms re: anesthesia during pin removal?

mistify

A little background: I am a PT who experienced a complete carpal ligament tear (L-T) and a chronic TFCC tear with chronic pain 10+ years which was finally affecting my work. On Nov 5th, I had an arthroscopic debridement and intercarpal pinning. At the time I had an axillary block and versed for sedation. At the time of the surgery, my pre-op pregnancy test was negative. Literally, days later, I missed my MP and tested positive (I was likely 3+ weeks at the time)...a complete surprise. (BTW, I'm 35 y/o first preg).

Well, now is time for pin removal. In preparation, my surgeon is getting clearance from OB (who is already aware of the situation). His note to OB states anesthesia as "local/MAC." He really thinks a block would be overkill. From what my OB says, he thinks the local is fine...and if I need a little sedation standing by, then thats OK (I'll be 11 weeks at the time)...but I should avoid it if possible

I know that MAC can mean minimal anesthetic concentration or minimal aveolar concentration, but what does this mean, really? What is he trying to tell my OB? I'd really like to do just local, but not sure if I'm being unrealistic. Procedure should take no more than 15-30 minutes, small incision requiring 1-2 stitches while they back out 3 k-wire pins. Furthermore, I'm guessing Versed is out, but is there something else that would be reasonable to take if I need it?

Like I said, I have a medical background, but this is outside my area of expertise.
Arnie,
Although I did not ask for you to wax philosophical on me, but since you opened the door, I will engage you. First, you have to remember that pain and nocioception are not the same thing. Nocioception is the peripheral stimulation that occurs from mechanical, thermal, chemical stimulation of nocioceptive nerves. Pain is the brain's complex response to a perceived threat that involves emotion, somatosensory information AND memory. In other words, pain is purely a cerebral event that does not always occur from nocioception nor does nocioception always result in pain. The role of versed is to block the input of the event on the brain..which it does quite well..which means the brains cannot form the imprint of a painful event. While your statement regarding the fact that its a "conscious sedation" may be true, the truth is that most people do "sleep" and are quite sedated during its use. Furthermore, if you will note above that I also had regional anesthesia
which blocks the actual nocioception. When used in combination, considering that Versed is fast acting and has a short duration, it really is ideal for most procedures.

Granted, in my case, I can't have it NOW because I am now pregnant, but as far as its use...I have no qualms with the situations under which I received it. In fact, I did become awake once during its use, but because of the regional anesthesia, I had no pain. Once they gave me another bolus, I remember nothing else.

I did not suffer, nor did your wife...pain is a cerebral event and versed is designed to block that. Sadly, the only person who suffered, was you...watching someone in pain can affect the same areas of the brain as being in pain oneself. Sorry you had to experience that. Sure, Versed can fail in some people, but thats true of any medication, I find no reason to go on a personal vendetta about the philosophy of it. Besides, propofol is also considered a amnestic drug along with several other benzodiaze

Answer
Hi there. MAC is Monitored Anesthesia Care - it means that you will have a local anesthetic but will have an anethetist recording all your vital signs. The MAC will put you into a "twilight sleep"and not a full anesthetic. You will not feel anything but will be aware of what is going on around you. The reason they us MAC is mostly for day surgeries providing they are not too serious. Your reason is obvious, because you are pregnant (congrats by the way). Either your surgeon or the anethatist will come and have a talk to you before your op so that you know what is going to happen. Good luck with the op and all the best for the arrival of your baby.

Trying to view wireless baby cam on my mac. what adapter do i need?!?

Roy R

i have a wireless baby monitor that connects to the yellow rca jack on a tv which we use in our kitchen. I want to start using the monitor to view our new born while in my office downstairs but I dont know what kind of cable i need to purchase for my imac (latest version).

I have a dvi to video connector that views the opposite way which shows the video from my computer to the tv but i need it the other way around this time.

Answer
This should take care of you:
XtraView - USB Video & Audio Capture for Mac

It comes with the ability to capture video to your Mac as well, but you can also use it just for casual viewing.

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