Available online 14 June 2025, 101037
To perform procedures in the interventional radiology suite, patient comfort and tolerance must be ensured through appropriate anesthesia and analgesia. Various levels of anesthesia can be utilized to safely accomplish a procedure from local anesthesia and mild sedation to general anesthesia. Depending on patient and procedural factors, different anesthetic plans may be beneficial. Patient factors such as chronic pain, hemodynamic stability, and complex medical problems will likely benefit from anesthesiologist involvement in the procedure. Procedural factors such as specific positioning requirements, following instructions, or invasiveness of the procedure may dictate what level of anesthesia is required, as well. Various anesthetic agents are used for amnesia, anesthesia, analgesia, and muscle relaxation. Understanding patients’ needs and procedural requirements will aid a clinician in performing safe and effective interventional procedures and maintain safety – from preoperative evaluation and monitoring during the procedure to discharging from the recovery room.
Section snippetsLevels of SedationThe American Society of Anesthesiology defines the levels of sedation as ranging from minimal sedation to general anesthesia (Table 1). These are defined by their effects on responsiveness, airway control (meaning the ability to maintain an open conduit from mouth/nose/atmosphere to the lungs), spontaneous breathing, and cardiovascular function.1 In lighter forms of sedation, a patient is responsive, has a patent, unaffected airway, breathes on their own, and has minimal change in their
SedationSeveral different medications can be used for procedural sedation (Table 2). The main medications used as sedatives today are propofol, dexmedetomidine, midazolam, ketamine, and etomidate.14 Propofol, midazolam, and etomidate are GABA agonists, dexmedetomidine is an alpha-2 agonist, and ketamine is an NMDA antagonist. All of these medications provide anesthesia, amnesia, and anxiolysis. Depending on the dosage, each medication can bring a patient to any level of sedation. Dexmedetomidine and
Declaration of Competing InterestNone
References (17)F.H. Cornelis et al.Sedation and analgesia in interventional radiology: where do we stand, where are we heading and why does it matter?Diagnostic and Interventional Imaging
(2019)
K.S. NasonAcute intraoperative pulmonary AspirationThorac Surg Clin
(2015)
Statement on continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia....T. HeideggerManagement of the difficult airwayN Engl J Med
(2021)
A.S. Weinstein et al.Comparison of preoperative assessment of patient's metabolic equivalents (METs) estimated from history versus measured by exercise cardiac stress testingAnesthesiol Res Pract
(2018)
T. Ladopoulos et al.Gastrointestinal dysmotility in critically ill patientsAnn Gastroenterol
(2018)
A. MiclescuChronic pain patient and anaesthesiaRom J Anaesth Intensive Care
(2019)
H.G. Jense et al.Effect of obesity on safe duration of apnea in anesthetized humansAnesth Analg
(1991)
There are more references available in the full text version of this article.
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