Safety of conscious sedation in interventional radiology.
OBJECTIVE
To identify rates of adverse events associated with the use of conscious sedation in interventional radiology.


METHODS
In a 5-month period, prospective data were collected on patients undergoing conscious sedation for interventional radiology procedures (n = 594). Adverse events were categorized as respiratory, sedative, or major adverse events. Respiratory adverse events were those that required oral airway placement, ambu bag, or jaw thrust. Sedation adverse events were unresponsiveness, oxygen saturation less than 90%, use of flumazenil/naloxone, or agitation. Major adverse events were hypotension, intubation, CPR, or cardiac arrest. The frequency of adverse events for the five most common radiology procedures were determined.


RESULTS
The five most common procedures (total n = 541) were biliary tube placement/exchange (n = 182), tunneled catheter placement (n = 135), diagnostic arteriography (n = 125), vascular interventions (n = 52), and other catheter insertions (n = 46). Rates for respiratory, sedation, and major adverse events were 4.7%, 4.2%, and 2.0%, respectively. The most frequent major adverse event was hypotension (2.0%). Biliary procedures had the highest rate of total adverse events (p < .05) and respiratory adverse events (p < .05).


CONCLUSIONS
The frequency of adverse events is low with the use of conscious sedation during interventional procedures. The highest rates occurred during biliary interventions.
Arepally
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A
The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cardiovascular and Interventional Radiology, Blalock 544, Johns Hopkins Medical Institutes, 600 N. Wolfe Street, Baltimore, MD 21287, USA. aarepall@rad.jhu.edu
Oechsle
D
D
Kirkwood
S
S
Savader
S J
SJ
D000759:Adjuvants, Anesthesia; D000328:Adult; D000368:Aged; D016292:Procedural Sedation / Q000009:adverse effects*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional; D018570:Risk Assessment
D000759:Adjuvants, Anesthesia; D008874:Midazolam; D005283:Fentanyl