Conscious sedation v. monitored anaesthesia care--20 years in the South African context.

Sedation of patients for minor procedures is here to stay. However, it is the responsibility of every physician to be aware of the potential complications associated with the combination of drugs administered and to practise in an environment where no risks are taken and no procedures performed outside the circle of safety. Furthermore, as an anaesthetic service, monitored anaesthesia care (MAC) is clearly distinct from moderate sedation and it is important for patient safety that these differences are recognised and adhered to. In essence, all practitioners must observe the strict distinctions between sedation and MAC to prevent the drift into deeper sedation under inappropriate circumstances.