Limits...
Safety and effectiveness of moderate sedation for radiologic non-vascular intervention.

Kim TH - Korean J Radiol (2006 Apr-Jun)

Bottom Line: 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%).The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dankook University Hospital, Chungnam, Korea. radiology@dankook.ac.kr

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 1.148 microg, it was 1.157 microg for PTGBD, 1 microg for AD, 1 microg for PCN, 1.641 microg for TDC, 1 microg for DJS, 2 microg for BS, 1 microg for GS and 2 microg 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.

Show MeSH

Related in: MedlinePlus

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)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2667585&req=5

Figure 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)

Mentions: 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). Figure 1 illustrates the distribution of the pre-procedural anxiety scores and the intraprocedural pain scores for all 72 procedures. Pain scores of 4 or less were recorded in 68 (94.4%) procedures. Four patients complained of pain scores greater than 5 during TDC (three patients) and BS (one patient). These patients received an incremental dose of sedative or analgesic and an incremental dose of lidocaine.


Safety and effectiveness of moderate sedation for radiologic non-vascular intervention.

Kim TH - Korean J Radiol (2006 Apr-Jun)

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)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667585&req=5

Figure 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)
Mentions: 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). Figure 1 illustrates the distribution of the pre-procedural anxiety scores and the intraprocedural pain scores for all 72 procedures. Pain scores of 4 or less were recorded in 68 (94.4%) procedures. Four patients complained of pain scores greater than 5 during TDC (three patients) and BS (one patient). These patients received an incremental dose of sedative or analgesic and an incremental dose of lidocaine.

Bottom Line: 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%).The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dankook University Hospital, Chungnam, Korea. radiology@dankook.ac.kr

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 1.148 microg, it was 1.157 microg for PTGBD, 1 microg for AD, 1 microg for PCN, 1.641 microg for TDC, 1 microg for DJS, 2 microg for BS, 1 microg for GS and 2 microg 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.

Show MeSH
Related in: MedlinePlus