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

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.