Korean J Radiol.  2006 Jun;7(2):125-130. 10.3348/kjr.2006.7.2.125.

Safety and Effectiveness of Moderate Sedation for Radiologic Non-Vascular Intervention

• Kim TH

• KMID: 1782185
• DOI: http://doi.org/10.3348/kjr.2006.7.2.125

Abstract

OBJECTIVE
The purpose of this study was to prospectively characterize the safety and effectiveness of moderate sedation/analgesia for performing radiologic non-vascular abdominal intervention. MATERIALS AND METHODS: During a 3-month period, a total of 63 adult patients with a mean age of 64 years (range: 27-82) underwent moderate sedation for 72 radiologic non-vascular interventional procedures. A combination of fentanyl citrate and midazolam hydrochloride, based on the patient's body weight, was intravenously administered until the patient was drowsy and tranquil. The adverse events associated with this moderate sedation were assessed. The visual analog scale format was used to measure the subjective feelings of the patient's pre-procedural anxiety and intraprocedural pain. RESULTS: The mean total dose per kilogram of body weight of fentanyl used in PTBD was 1.148ug, it was 1.157ug for PTGBD, 1ug for AD, 1ug for PCN, 1.641ug for TDC, 1ug for DJS, 2ug for BS, 1ug for GS and 2ug for RFA. The mean total dose per kilogram of body weight of midazolam was 0.035 mg in PTBD, PTGBD, AD, PCN, DJS, GS and RFA, 0.039 mg in TDC, and 0.043 mg in BS. A temporary reduction of systolic blood pressure to less than 80 mmHg was observed during 5 procedures (6.9%), whereas a temporary elevation of systolic blood pressure above 150 mmHg was observed during 10 procedures (13.8%). A reduction of arterial oxygen saturation to less than 90% was observed during 14 procedures (19.4%). None of the patients required pharmacologic reversal agents or cardiopulmonary resuscitation. The mean anxiety score recorded before all procedures was 5.2 (distressing). The mean pain score during the procedure, which was recorded after all procedures, was 2.9 (mild). CONCLUSION: Moderate sedation allows performance of safe and effective radiologic non-vascular intervention, and it is also easy for an interventional radiologist to use. The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures.

Keyword

Anesthesia; Abdomen, interventional procedures

MeSH Terms

*Radiography, Interventional
Prospective Studies
Middle Aged
Midazolam/administration & dosage
Male
Hypnotics and Sedatives/administration & dosage
Humans
Fentanyl/administration & dosage
Female
*Conscious Sedation
Analgesics, Opioid/administration & dosage
Aged, 80 and over
Aged
Adult

Figure

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  Fig. 1 The pre-procedural anxiety is mainly distributed in the midscores (distressing) and the intraprocedural pain is mainly distributed in low-scores (mild). (Note: 0, none; 1-2, mild; 3-4, discomforting; 5-6, distressing; 7-8, horrible; and 9-10, excruciating)

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