Chapter 23 - Sedation for interventional pain management procedures

Summary

The administration of anesthetics for moderate and deep sedation during pain management procedures is a challenge to any provider. Practitioners must be aware of the specific characteristics of their location to ensure patient safety. The American Society of Anesthesiologists (ASA) has established several guidelines including the requirements for anesthesia delivery in an office-based setting and for interventional pain procedures. Appropriate pre-procedural evaluation of each patient is recommended by the ASA. The pre-assessment allows for reduction in risk of adverse outcomes and in turn leads to improved patient outcomes. Adequate monitoring of ventilatory function via observation of chest rise and auscultation is recommended to avoid adverse outcomes. In addition to physiologic monitoring, assessment of level of sedation and pain is vital for adequate sedation for pain procedures. Various sedatives, opioids, and dissociative agents are used in the management of patients undergoing pain procedures.