Summary:
UCLA researchers in the Department of Anesthesiology and Perioperative Medicine have developed a unique non-opioid mixture of sedatives for monitored anesthesia care (MAC) in surgical and diagnostic procedures providing high quality of sedation, which is quantitatively predictable and measurable in dose determination, time to reach the target level of sedation, efficacy of analgesia, and incidence of airway complications.
Background:
Monitored anesthesia care (MAC), or intravenous sedation, is widely used to anesthetize patients for diagnostic and surgical procedures. Despite its common use patient injury under the technique may occur due to the variability in the selection, the delivery, and the dose determination of the medications. In addition, there is no standardized or quantitatively measurable technique(s) in giving MAC. Although opioids can provide profound and needed analgesia for patients undergo surgery, their use often lead to addiction, and potential injury and death associated with opioid overdose. Due to opioid pandemic in the US, there is a urgent need for standardized non-opioid formula and technique not only to prevent opioid addition, but also to provide adequate sedation and analgesia which is compatible to opioid-base technique(s) in order to improve patient safety and satisfaction.
Innovation:
UCLA researchers have developed a safe and effective anesthetic mixture that can be used in patients undergo surgical and diagnostic procedures under MAC safely. The mixture uses three medically approved and opioid free analgesics. The bolus dose is determined by patient’s age and weight, which is safely pushed in a few seconds by infusion pump or hand. The onset time (the time required to reach the target level of moderate sedation) is predictably about one minute or less. 90% or more patients feel no pain, anxiety or discomfort during regional blocks or recall of blocks , and <2% risk of airway complications (apnea, requirement of chin lifting, jaw thrust or mask ventilation). The use of this mixture can potentially standardize and commercialize the anesthetic technique of MAC in the broad practice of intravenous sedation not only providing state-of-the-art level of MAC but also improving patient safety.
Source: Prof. Zhuang T. Fang
Potential Applications:
- Monitored Anesthesia Care (MAC) for diagnostic or therapeutic procedures, including ophthalmic, podiatric and general surgery, colonoscopy, etc.
Advantages:
- The mixture is opioid free, but the analgesic effect is comparable to that of the opioid-base mixture(s) developed by the same inventor (Dr. Fang) at UCLA.
- The bolus dose is accurately determined by patient’s age and weight.
- The bolus dose can be safely delivered by infusion pump or hand push.
- The time to reach the target level of sedation is consistently about one minute or less.
- The efficacy for anxiolytics, analgesia and amnesia is predictable in 90% of patients.
- The incidence of apnea, hypoxia and need for airway support is about 2% or less.
- Maintain hemodynamic stability
Development to Date:
It has been successfully used in anesthesia practice at UCLA in ophthalmic surgery, including glaucoma surgery, retinal surgery, corneal transplantation, orbitotomy, dacryocystorhinostomy, podiatric and general surgery, and colonoscopy.