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

Abstract

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. 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. This audit was undertaken in 2 interventional spine practices. A total of 102 patients were allotted to receive or not receive intravenous sedation depending on preference. Interlaminar epidural injections of corticosteroid without epidural anesthetic. Outcomes were measured by mean (VAS) scores after the procedure and mean VAS differences before and after the procedure. 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. 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.