A survey: conscious sedation with epidural and zygapophyseal injections: Is it necessary?

Abstract

Background context Substantial variation exists regarding the use of sedation before interventional spine techniques. Patient preference should play an important role in decision making regarding the need for sedation. However, little is known about patients' anxiety levels before spinal injections and their perceptions about the necessity of sedation. Purpose To determine patient perception for need for sedation before epidural steroid injections and zygapophyseal joint injections. Study design/setting Survey of consecutive spinal injection patients in an outpatient spine center. Patient sample 500 consecutive lumbar, thoracic, and cervical patients receiving spinal injections. Outcome measures A 12-item questionnaire assessing patients' perceived anxiety before to a spinal injection. Methods Subjects were given the questionnaire after their spinal injection. Percentages requesting sedation for a first and potential second procedure were assessed. Additionally, anxiety level and pain rating, location of injection, age, sex, and other medication use were analyzed to determine the effect on the request for sedation. Results 17% of patients questioned requested sedation before an injection, and 28% would request sedation if they were to have a second injection. Conclusions Routine sedation before diagnostic and therapeutic injections is not necessary as the majority of patients would not request sedation before the procedure when given the option. However, in some patients sedation is indicated, and all patients would benefit from educational material on sedation before the injection.