Effect of the centers for medicare & medicaid services policy about deep Sedation on Use of propofol

Douglas K. Rex

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Centers for Medicare & Medicaid Services issued a policy stating that deep sedation can only be administered by an anesthesiologist, a certified registered nurse anesthetist, or a trained medical doctor or a doctor of osteopathy not involved in the performance of a medical procedure. Propofol is a popular sedation agent that is usually administered by anesthesia specialists in a service termed monitored anesthesia care (MAC). Monitored anesthesia care adds substantial new fees to procedural sedation. However, available evidence shows that propofol can be used safely by nonanesthesiologists for procedural sedation. The American Society of Anesthesiologists considers that propofol implies deep sedation and should only be administered by anesthesia specialists. The Centers for Medicare & Medicaid Services policy on deep sedation can be viewed as supporting an ongoing conversion to MAC to deliver propofol for procedural sedation. However, the absence of an evidence base supporting a need for MAC to deliver propofol, combined with its high cost, suggests that alternatives to MAC to deliver propofol deserve fair and balanced evaluation.

Original languageEnglish (US)
Pages (from-to)622-626
Number of pages5
JournalAnnals of internal medicine
Volume154
Issue number9
DOIs
StatePublished - May 3 2011

ASJC Scopus subject areas

  • Internal Medicine

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