Sedation and Analgesia in the Performance of Interventional Procedures

ABSTRACT

Interventional procedures can produce pain, anxiety, and physical and mental distress. Analgesia and sedation in the interventional radiology suite are given routinely during interventional procedures and allow a safe, comfortable, and technically successful procedure to be performed. Appropriate sedation decreases patient movement, patient anxiety, pain perception, and is crucial to successfully perform percutaneous interventions. A thorough understanding of the preoperative patient assessment, intraprocedural monitoring, pharmacologic characteristics of medications, postoperative care, and treatment of complications is required for the practicing interventionalist. Complications related to sedation and analgesia can occur secondary to preexisting medical conditions, incorrect drug administration, and/or inadequate patient monitoring.[1] [2]

KEYWORDS

Sedation - analgesia - amnesia - Mallampati scoring

REFERENCES

• 1 Martin M L, Lennox P H. Sedation and analgesia in the interventional radiology department.  J Vasc Interv Radiol. 2003;  14(9 Pt 1) 1119-1128
• 2 ASA Task Force on Sedation and Analgesia by Non-Anesthesiologists . Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists.  Anesthesiology. 2002;  96 1004-1017
• 3 Schupp C J, Berbaum K, Berbaum M, Lang E V. Pain and anxiety during interventional radiologic procedures: effect of patients' state anxiety at baseline and modulation by nonpharmacologic analgesia adjuncts.  J Vasc Interv Radiol. 2005;  16(12) 1585-1592
• 4 Lang E V, Benotsch E G, Fick L J et al.. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial.  Lancet. 2000;  355(9214) 1486-1490
• 5 Koch M E, Kain Z N, Ayoub C, Rosenbaum S H. The sedative and analgesic sparing effect of music.  Anesthesiology. 1998;  89(2) 300-306
• 6 Lang E V, Porter D H. Analgesia and sedation for interventional procedures. In: Murphy TP, Benenati JF, Kaufman JA Syllabus SCVIR. Patient Care in Interventional Radiology. Fairfax, VA; Society of Cardiovascular and Interventional Radiology 1999: 65-91
• 7 Mueller P R, Biswal S, Halpern E F, Kaufman J A, Lee M J. Interventional radiologic procedures: patient anxiety, perception of pain, understanding of procedure, and satisfaction with medication—a prospective study.  Radiology. 2000;  215(3) 684-688
• 8 Lang E V, Chen F, Fick L J, Berbaum K S. Determinants of intravenous conscious sedation for arteriography.  J Vasc Interv Radiol. 1998;  9(3) 407-412
• 9 Arepally A, Oechsle D, Kirkwood S, Savader S J. Safety of conscious sedation in interventional radiology.  Cardiovasc Intervent Radiol. 2001;  24(3) 185-190
• 10 Wagner H J, Nowacki J, Klose K J. Propofol versus midazolam for sedation during percutaneous transluminal angioplasty.  J Vasc Interv Radiol. 1996;  7(5) 673-680
• 11 Krauss B, Green S M. Sedation and analgesia for procedures in children.  N Engl J Med. 2000;  342(13) 938-945
• 12 Bailey P L, Pace N L, Ashburn M A, Moll J W, East K A, Stanley T H. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl.  Anesthesiology. 1990;  73(5) 826-830
• 13 Trotteur G, Stocksx L, Dondelinger R F. Sedation, analgesia, and anesthesia for interventional radiologic procedures. Part 1: Survey of interventional radiology practice in Belgium.  Br J Radiol. 2000;  83 111-115
• 14 Cotsen M R, Donaldson J S, Uejima T, Morello F P. Efficacy of ketamine hydrochloride sedation in children for interventional radiologic procedures.  AJR Am J Roentgenol. 1997;  169(4) 1019-1022
• 15 Reynolds F. Maximum recommended doses of local anesthetics: a constant cause of confusion.  Reg Anesth Pain Med. 2005;  30(3, Issue 3) 314-316