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Background Today the availability of new local anesthetics and the use of analgesics, allow the modulation of the analgesia, maintaining a state of consciousness. An answer to the needs of patients >75 years undergoing surgery is the technique Monitored Anesthesia Care (MAC), defined “the middle land” (Figure 1). MAC allows: the modulation of the level of analgesia at different stages of surgery due to the availability of analgesic action, but with rapid onset-time the additional analgesia using local anesthetics with prolonged effect without the use of noradrenaline, dangerous for elderly patients the consciousness and cooperation of the patient (Table 1).

Quid novi in the eldery patient’s anesthesia