Sedation and Pain killers in the Interventional Radiology

Abstract

Introduction: Decisions regarding the use of sedatives and analgesics during interventional radiology (IR) procedures were primarily determined by habits and philosophies of the institution and that neither patient anxiety and pain scores nor physician decisions affected drug utilization. This review highlighted the articles that focused on the use of sedation or analgesic procedure during interventional radiology.
Methods: A systematic MEDLINE/PubMed literature search was performed with different combinations of search terms. The eligibility criteria included addressing pre- or post-operative pain control during interventional radiology. The full-text of the eligible articles were retrieved and two independent reviewers extract the information concerning sedation and pain killers from the eligible studies. Further exclusion of irrelevant articles were made based on the in-depth reading. The findings were discussed in a narrative data synthesis in the following section.
Results: Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Weight-based protocols for procedural sedation have demonstrable benefit, protocols for postprocedural pain relief after major procedures have not been sufficiently rigorously evaluated.
Conclusions: Protocols for postprocedural pain relief after more invasive procedures such as UAE have not been rigorously evaluated. However, a regimen comprised of an opioid PCA combined with a regular oral NSAID and an antiemetic is sufficient for the majority of patients.