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

PM R. 2009 Jan;1(1):60-3. doi: 10.1016/j.pmrj.2008.10.006. Epub 2008 Dec 10.

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.

Publication types

  • Multicenter Study

MeSH terms

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

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents