Sedation and Analgesia in Interventional Radiology

ABSTRACT

Complex medical procedures requiring the administration of sedation and analgesia are frequently performed in sites outside the operating room. In particular, interventional radiologists must understand basic principles of sedation and analgesia to direct nurses or nurse practitioners to provide adequate conscious sedation. The purpose of this article is to review basic principles of sedation, pharmacologic agents used for sedation and analgesia, practice guidelines, monitoring, and management of common hemodynamic problems encountered during sedation.

KEYWORDS

Sedation - analgesia - practice guidelines - nonanesthesiologist

REFERENCES

• 1 American Society of Anesthesiologists Task Force on Sedation by Nonanesthesiologists . Practice guidelines for sedation and analgesia by non-anesthesiologists.  Anesthesiology. 2002;  96 1004-1017
• 2 Practice guidelines for preoperative fasting and the use of pharmacologic agents for the prevention of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting . Anesthesiology. 1999;  90 896-905
• 3 Roberts R B, Shirley M A. Reducing the risk of gastric aspiration during cesarean section.  Anesth Analg. 1974;  53 859-868
• 4 Rocke D A, Brock-Utne J G, Rout C C. At risk for aspiration: new critical values of volume and pH?.  Anesth Analg. 1993;  76 666
• 5 Vargo J J, Zuccaro G, Dumot J et al.. Gastroenterologist-administered propofol versus meperidine and midazolam for advanced upper endoscopy: a prospective randomized trial.  Gastroenterology. 2002;  123 8-16
• 6 Rex D K, Sipe B W, Kinser K M et al.. Safety of propofol administered by registered nurses with gastroenterologist supervision in 2,000 endoscopic cases.  Am J Gastroenterol. 2002;  97 1159-1163
• 7 Wittels E H, Thompson S. Obstructive sleep apnea and obesity.  Otolaryngol Clin North Am. 1990;  23 751-760
• 8 Barash PG, Cullen BF, Stoelting RK Clinical Anesthesia. 2nd ed. Philadelphia; JB Lippincott 1992: 1559
• 9 Morgan GE, Mikhail MS Clinical Anesthesiology. 2nd ed. Stamford, CT; Appleton & Lange 1996: 304