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Pain control during interventional biliary procedures: epidural anesthesia vs i.v. sedation
D L Harshfield1, S K Teplick, J C Brandon
1Department of Radiology, University of Arkansas for Medical Sciences, Little Rock 72205.
AJR. American Journal of Roentgenology
|November 1, 1993
Summary
Epidural anesthesia is more effective than IV sedation for managing pain during biliary procedures, with fewer complications. This makes it a justified choice despite higher costs and time.
Area of Science:
- Medical Procedures
- Anesthesiology
- Pain Management
Background:
- Interventional biliary procedures can cause significant pain.
- Effective pain control is crucial for patient comfort and procedural success.
Purpose of the Study:
- To compare the efficacy of epidural anesthesia versus intravenous (IV) sedation for pain control during transhepatic biliary procedures.
Main Methods:
- A study involving 263 biliary procedures in 126 patients over 3 years.
- Pain was subjectively rated by patients (0-3 scale).
- Epidural anesthesia (140 procedures) and IV sedation (123 procedures) were compared.
Main Results:
- Epidural anesthesia provided mild to no pain in 91% of cases, versus 50% with IV sedation.
- Complications, primarily hypotension, were more frequent with IV sedation (5%) compared to epidural anesthesia (<1%).
Conclusions:
- Epidural anesthesia is significantly more effective than IV sedation for eliminating moderate to severe pain during biliary procedures.
- The higher efficacy and safety profile of epidural anesthesia justify its use despite increased time and cost.