PM&R
Volume 1, Issue 1 , Pages 60-63, January 2009

Is Immediate Pain Relief After a Spinal Injection Procedure Enhanced by Intravenous Sedation?

  • Paul Dreyfuss, MD

      Affiliations

    • Department of Rehabilitation Medicine, University of Washington, 12301 NE 10th Place, Suite 101, Bellevue, WA 98004⁎
    • Corresponding Author InformationAddress correspondence to: P.D.
    • ,
  • Steven Cohen, MD

      Affiliations

    • Department of Anesthesia and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, and Walter Reed Medical Center, Washington, DC⁎
    • ,
  • Allen Sinclair Chen, MD, MPH

      Affiliations

    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA⁎
    • ,
  • Zach Bohart, MD, MS

      Affiliations

    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA⁎
    • ,
  • Nikolai Bogduk, MD, PhD, Dsc

      Affiliations

    • Department of Clinical Research, University of Newcastle, Royal Newcastle Hospital, New South Wales, Australia⁎

Received 17 June 2008; accepted 10 October 2008. published online 11 December 2008.

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.

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  • ⁎ Disclosure: nothing to disclose
  • ⁎ Disclosure: nothing to disclose
  • ⁎ Disclosure: nothing to disclose
  • ⁎ Disclosure: nothing to disclose
  • ⁎ Disclosure: nothing to disclose

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(08)00013-0

doi:10.1016/j.pmrj.2008.10.006

PM&R
Volume 1, Issue 1 , Pages 60-63, January 2009

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