Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-10 - OFFICE-BASED SURGERY › Section 540-X-10-.02 - Definitions - Levels Of Anesthesia

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Local Anesthesia. The administration of
			 an agent which produces a localized and reversible loss of sensation in a
			 circumscribed portion of the body.
(2) Minimal Sedation (anxiolysis). A
			 drug-induced state during which patients respond normally to verbal commands.
			 Although cognitive function and coordination may be impaired, ventilatory and
			 cardiovascular functions are unaffected.
(3) Moderate Sedation/Analgesia ("Conscious
			 Sedation"). A drug-induced depression of consciousness during which a patient
			 responds purposefully to verbal commands, either alone or accompanied by light
			 tactile stimulation. Reflex withdrawal from painful stimulation is
NOT
considered a purposeful response. No interventions are
			 required to maintain a patent airway, and spontaneous ventilation is adequate.
			 Cardiovascular function is usually maintained.
(4) Deep Sedation/Analgesia. A drug-induced
			 depression of consciousness during which patients cannot be easily aroused but
			 respond purposefully following repeated or painful stimulation. Reflex
			 withdrawal from painful stimulation is
NOT
considered a purposeful
			 response. The ability to independently maintain ventilatory function may be
			 impaired. Patients may require assistance in maintaining a patent airway, and
			 spontaneous ventilation may be inadequate. Cardiovascular function is usually
			 maintained.
(5) General Anesthesia.
			 A drug-induced loss of consciousness during which patients are not arousable,
			 even by painful stimulation. The ability to independently maintain ventilatory
			 function is often impaired. Patients often require assistance in maintaining a
			 patent airway, and positive pressure ventilation may be required because of
			 depressed spontaneous ventilation or drug-induced depression of neuromuscular
			 function. Cardiovascular function may be impaired.
(6) Regional Anesthesia ("Major conduction
			 blockade") is considered in the same category as General Anesthesia.5
(7) Because sedation is a continuum, it is
			 not always possible to predict how an individual patient will respond. Hence,
			 practitioners intending to produce a given level of sedation should be able to
			 rescue patients whose level of sedation becomes deeper than initially intended.
			 Individuals administering Moderate Sedation/Analgesia ("Conscious Sedation")
			 should be able to rescue patients who enter a state of Deep Sedation/Analgesia,
			 while those administering Deep Sedation/Analgesia should be able to rescue
			 patients who enter a state of general anesthesia.
Authors:
Alabama Board of Medical Examiners
ad hoc
Committee: Arthur F. Toole, III, M.D.; Jorge A. Alsip,
				M.D.; James G. Chambers, III, M.D.; Craig H. Christopher, M.D.; Alcus Ray
				Hudson, M.D.; Pamela D. Varner, M.D.; James E. West, M.D.; and Task Force
				Sub-Committee: Jeff Plagenhoef, M.D.; Eric Crum, M.D.; Dan J. Coyle, Jr., M.D.;
				Gary Monheit, M.D.; Robert Hurlbutt, IV, M.D.; C. Paul Perry, M.D.; W. Guinn
				Paulk, M.D.; Mark McIlwain, D.M.D., M.D.; Jerald Clanton, D.M.D., M.D.; Patrick
				J. Budny, M.D.; James W. Northington, M.D.; David Franco, M.D.; Thomas E.
				Moody, M.D.
Statutory Authority:
Code of Ala.
				  1975
, §
										34-24-53.