Is immediate pain relief after a spinal injection procedure enhanced by intravenous sedation?

Abstract

OBJECTIVE:

To determine the effect of intravenous sedation on postprocedural pain relief for patients undergoing a spinal injection procedure in which there is no expectation of immediate relief.

DESIGN:

A prospective audit to compare Visual Analog Scale (VAS) responses before and after interlaminar epidural corticosteroid injections without epidural anesthetic in those who did and did not receive intravenous sedation.

SETTING:

This audit was undertaken in 2 interventional spine practices.

PATIENTS:

A total of 102 patients were allotted to receive or not receive intravenous sedation depending on preference.

INTERVENTIONS:

Interlaminar epidural injections of corticosteroid without epidural anesthetic.

MAIN OUTCOME MEASUREMENTS:

Outcomes were measured by mean (VAS) scores after the procedure and mean VAS differences before and after the procedure.

RESULTS:

There were no significant differences between mean VAS scores or mean differences in VAS scores between those who did or did not receive intravenous sedation. A relatively high percentage of patients in both groups obtained greater than 50% immediate pain relief.

CONCLUSION:

Intravenous mild or moderate conscious sedation did not have an effect on postprocedural VAS pain scores in those receiving a therapeutic spinal injection procedure. Immediate pain relief was most likely the result of nonspecific effects.

• Authors: Paul Dreyfuss, Steven Cohen, Allen Sinclair Chen, Zach Bohart, Nikolai Bogduk
• Journal: PM & R : the journal of injury, function, and rehabilitation (PM R) Vol. 1 Issue 1 Pg. 60-3 (Jan 2009) ISSN: 1934-1482 [Print] United States
• PMID: 19627874 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Adrenal Cortex Hormones
• Anti-Inflammatory Agents

Topics

• Adrenal Cortex Hormones (administration & dosage)
• Anesthesia, Intravenous
• Anti-Inflammatory Agents (administration & dosage)
• Conscious Sedation
• Humans
• Injections, Epidural
• Pain (drug therapy)
• Pain Measurement
• Prospective Studies