Abstract
This CIRSE Standards of Practice document provides best practices for the safe administration of procedural sedation and analgesia for interventional radiology procedures in adults. The document is aimed at health professionals involved in the provision of sedation and analgesia during interventional radiology procedures. The document has been developed by a writing group consisting of physicians with internationally recognised expertise in interventional radiology, and analgesia and sedation.
Similar content being viewed by others
References
Green SM, Krauss B. Procedural sedation terminology: moving beyond “conscious sedation”. Ann Emerg Med. 2002;39:433–5. https://doi.org/10.1067/mem.2002.122770.
Hatzidakis AA, Charonitakis E, Athanasiou A, et al. Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage. Clin Radiol. 2003;58:121–7. https://doi.org/10.1053/crad.2002.1128.
Hinkelbein J, Lamperti M, Akeson J, et al. European society of anaesthesiology and european board of anaesthesiology guidelines for procedural sedation and analgesia in adults. Eur J Anaesthesiol. 2018;35:6–24. https://doi.org/10.1097/EJA.0000000000000683.
Dumonceau JM, Riphaus A, Schreiber F, et al. Endoscopy. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy. European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline. 2015;47:1175–89. https://doi.org/10.1055/s-0034-1393414.
Gouda B, Gouda G, Borle A, et al. Safety of non-anesthesia provider administered propofol sedation in non-advanced gastrointestinal endoscopic procedures: a meta-analysis. Saudi J Gastroenterol. 2017;23:133–43. https://doi.org/10.4103/sjg.SJG_501_16.
Sury M, Bullock I, Rabar S, Demott K. Sedation for diagnostic and therapeutic procedures in children and young people : summary of NICE guidance. BMJ. 2011;342:45–8. https://doi.org/10.1136/bmj.c6819.
Vargo JJ, Cohen LB, Rex DK, Kwo PY. Position statement: nonanesthesiologist administration of propofol for GI endoscopy. Gastrointest Endosc. 2009;50:1683–9. https://doi.org/10.1002/hep.23326.
ASA. Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American. Anesthesiology. 2018;128:437–79. https://doi.org/10.1097/ALN.0000000000002043.
The Royal College of Radiologists (2018) Sedation, analgesia and anaesthesia in the radiology department (second edition).
Commission The Joint. 2016. https//www.jointcommission.org/Stand.jcfaqdetails.aspx?StandardsFaqId=1240&ProgramId=46. Accessed 25 Aug 2016.
ASA. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: an updated report by the american society of anesthesiologists com. Anesthesiology. 2017;126:376–93. https://doi.org/10.1097/ALN.0b013e3181fcbfd9.
Kriegshauser J, Osborn H, Naidu S, et al. Developing interventional radiology anticoagulation guidelines: process and benefits. J Clin Med. 2018;7:85. https://doi.org/10.3390/jcm7040085.
Patel IJ, Davidson JC, Nikolic B, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 2012;23:727–36. https://doi.org/10.1016/j.jvir.2012.02.012.
Lee MJ, Fanelli F, Haage P, et al. Patient safety in Interventional radiology: a CIRSE IR checklist. Cardiovasc Intervent Radiol. 2012;35:244–6. https://doi.org/10.1007/s00270-011-0289-5.
World Health Organization (2009) Surgical Safety Checklist https://www.who.int/patientsafety/safesurgery/checklist/en/. Accessed 22 April 2020.
Purdon PL, Sampson A, Pavone KJ, et al. Clinical electroencephalography for anesthesiologists: part I: background and basic signatures. Anesthesiology. 2015;123:937–60. https://doi.org/10.1097/ALN.0000000000000841.
Ead H. From aldrete to PADSS: reviewing discharge criteria after ambulatory surgery. J Perianesth Nurs. 2006;21:259–67.
Funding
This study was not supported by any funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
S Romagnoli received grants for consultancy and support for travel expenses, hotel accommodations and registration to meetings, from Baxter, B. Braun, Pall International, Orion Pharma, Medigas, Medtronic and Vygon. The other authors declare that they have no conflicts of interest.
Ethical approval
For this type of study, informed consent is not required.
Informed consent
Not applicable.
Consent to publish
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendix: ASA recommendations for fasting before sedation, anaesthesia and procedures
Appendix: ASA recommendations for fasting before sedation, anaesthesia and procedures
-
Clear liquids may be ingested for up to 2 h before procedures requiring general anaesthesia, regional anaesthesia, or procedural sedation and analgesia.
-
A light meal or non-human milk may be ingested for up to 6 h before elective procedures requiring general anaesthesia, regional anaesthesia, or procedural sedation and analgesia.
-
Additional fasting time (e.g. 8 or more hours) may be needed in cases of patient intake of fried food, fatty food or meat.
-
Both the amount and type of food ingested must be taken into account when determining an appropriate fasting period.
-
Since non-human milk is similar to solids in gastric emptying time, consider the amount ingested when determining an appropriate fasting period.
-
In the case of urgent or emergent situations where gastric emptying is not possible, do not delay moderate procedural sedation procedure based on fasting time alone; this condition may require an anaesthetic involvement/referral.
-
Refer to the specific guideline for additional details [10].
Rights and permissions
About this article
Cite this article
Romagnoli, S., Fanelli, F., Barbani, F. et al. CIRSE Standards of Practice on Analgesia and Sedation for Interventional Radiology in Adults. Cardiovasc Intervent Radiol 43, 1251–1260 (2020). https://doi.org/10.1007/s00270-020-02536-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-020-02536-z