Patterns of anesthesia and nursing care for interventional radiology procedures: a national survey of physician practices and preferences.

Abstract

The data supply useful background information regarding the use of anesthesia, periprocedural monitoring, clinical assessment, and nursing care.

Sedation shared decision-making in ambulatory venous access device placement: Effects on patient choice, satisfaction and recovery time

“…[18][19][20][21][22][23] Despite the success of these techniques, placement of TIVAP and PIVAD in interventional radiology in the USA is performed primarily under procedural sedation using intravenous pharmacologic agents. 3,4 The multiple proven methods to ease patient anxiety, including non-pharmacologic and a range of pharmacologic therapies, present an opportunity to employ shared decision-making so that patients can select the option that is most aligned with their comfort level. For instance, the ability to undergo TIVAP and PIVAD placement without sedation might be desirable for a patient who wishes to resume their activities immediately without limitation or prolonged recovery time.…”

“…Moderate procedural sedation (combination of an opioid for pain control and a benzodiazepine, which serves as an anxiolytic while promoting amnesia) is used in the majority of these procedures. [3][4][5] The disadvantages of sedation include the risk of increased cardiopulmonary complications, side effects, the need for an escort home, disruption of daily activities, time off work requirement, peri-procedure time (turnaround in the procedure room and occupancy of recovery area) and cost to the healthcare system. 6 There is a widespread assumption that patients who receive deeper sedation for brief procedures are more satisfied.…”

Safety and Effectiveness of Analgesia with Remifentanil for Percutaneous Transhepatic Biliary Drainage

“…The achievement of adequate sedation and analgesia during an IR proce dure is essential [1,2]. The most popular se dation and analgesia method for IR proce dures involves a combination of fentanyl and midazolam [3][4][5][6]. Although this method is accepted as safe and effective, some reports [7][8][9] have emphasized the risks of respiratory and cardiovascular side effects.…”

Anaesthetists and Sedation in the Radiology Department: Involved or left behind?

“…Indeed the Joint Colleges' document of 2001 [1] states that every hospital should have a consultant Anaesthesia, 2005, 60, pages 423-425 ................................................................................................................................................................................................................ In adult interventional radiology current standards and practice are unclear. A survey of 634 American interventional radiologists published in Radiology in 1997 [11] analysed 500 000 procedures where sedation was used by radiologists. The authors commented that, despite the large and increasing number of interventions, ''there is little literature (not only in the radiology literature but even in the anesthetic literature) on the amount of monitoring and clinical care given to these patients'' and ''on the types and degree of analgesia or anesthesia used''.…”

“…The mainstay of current techniques is midazolam, used by over 90% of interventional radiologists [11]. Opioids are frequently added, 60% using fentanyl and 40% using morphine.…”