An interventionalist’s guide to analgesia and sedation: principles, practices, and managing complications

The purpose of this educational exhibit is to explore the principles, practices and ways to identify and manage the complications of analgesia and sedation used in Interventional Radiology (IR) procedures. We will identify what and how different agents are used in terms of analgesia and sedation as well as provide case based examples in practical IR situations. Analgesia and/or sedation is used in almost all interventional radiology (IR) procedures. It is important for the interventionalist to become familiar with the commonly used agents, techniques for administration and identification/treatment of complications related to their use. The majority of procedures performed in the IR suite involve the use of conscious sedation. It is therefore important for the interventionalist to not only identify complications such as respiratory depression, hypotension and bradycardia; but to also properly manage these patients in the acute setting. Key components prior to administration: Allergies, History/Physical, Medication reconciliation, Vitals, Labs, ASA Types of Analgesia/Sedation: Topical, Local blocks, Light to Moderate Sedation, Induction, Paralytics, General Anesthesia. Complications: Respiratory depression, Cardiac arrhythmias, Hypotension, Hypertension, Cardiac arrest, Drug-Drug interactions Management: Airway support/Ventilation, Medications/Dosages, Vitals/Monitoring, Calling a Code/Utilizing a crash cart Case based Review: Typical percutaneous procedures, Venous procedures, Arterial procedures, Pediatrics, Elderly, High-Risk patients Analgesia and sedation play a vital role in interventional radiology (IR) procedures. It is important for interventionalists to be familiar with the principles, practices and management of complications related to the use of these various agents.