title: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  This audit was undertaken in 2 interventional spine practices.
  
  
  METHODS
  A total of 102 patients were allotted to receive or not receive intravenous sedation depending on preference.
  
  
  METHODS
  Interlaminar epidural injections of corticosteroid without epidural anesthetic.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Rehabilitation Medicine, University of Washington, Bellevue, WA 98004, USA. pauldreyfuss@gmail.com
authors.forename: Paul
authors.initials: P
authors.lastname: Dreyfuss
authors.forename: Steven
authors.initials: S
authors.lastname: Cohen
authors.forename: Allen Sinclair
authors.initials: AS
authors.lastname: Chen
authors.forename: Zach
authors.initials: Z
authors.lastname: Bohart
authors.forename: Nikolai
authors.initials: N
authors.lastname: Bogduk
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000771:Anesthesia, Intravenous; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D016292:Procedural Sedation; D006801:Humans; D007268:Injections, Epidural; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents