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Statement On Anesthetic Care During Interventional Pain Procedures For Adul

This document from the American Society of Anesthesiologists discusses guidelines for anesthetic care during interventional pain procedures for adults. It recognizes that sedation or anesthesia may be needed to balance risk during painful procedures but also constitutes a separate service requiring specific training. For most patients, the physician performing the procedure can provide moderate sedation, but some high-risk procedures may require a separate provider with anesthesia skills. Pediatric patients also often require sedation due to age-related considerations.

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127 views1 page

Statement On Anesthetic Care During Interventional Pain Procedures For Adul

This document from the American Society of Anesthesiologists discusses guidelines for anesthetic care during interventional pain procedures for adults. It recognizes that sedation or anesthesia may be needed to balance risk during painful procedures but also constitutes a separate service requiring specific training. For most patients, the physician performing the procedure can provide moderate sedation, but some high-risk procedures may require a separate provider with anesthesia skills. Pediatric patients also often require sedation due to age-related considerations.

Uploaded by

Steve aoki
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Statement on Anesthetic Care During Interventional Pain Procedures for Adults

Committee of Origin: Pain Medicine

(Approved by the ASA House of Delegates on October 22, 2005 and last amended
on October 26, 2016)

The use of moderate (conscious) sedation and/or anesthesia during the performance of pain
procedures must be balanced with the potential risk of harm from doing pain procedures in sedated
patients. The Committee recognizes the provision of sedation or anesthesia as a separate and
distinct service from the pain procedure and thus requiring specific training and credentialing. For
more information, see the ASA Statement on Granting Privileges for Administration of Moderate
Sedation to Practitioners Who Are Not Anesthesia Professionals. The Committee also notes that
when moderate (conscious) sedation is provided during the performance of a pain procedure, it
should allow the patient to be responsive during critical portions of the procedure, e.g., to report
any procedure-related change in pain intensity, function and/or paresthesia.

Many patients can undergo interventional pain procedures without the need for supplemental
sedation in addition to local anesthesia. For most patients who require supplemental sedation, the
physician performing the interventional pain procedure(s) can provide moderate (conscious)
sedation as part of the procedure. For a limited number of patients a second provider may be
required to manage moderate or deep sedation or, in selected cases other anesthesia services.
Examples of procedures that typically do not require sedation include but are not limited to epidural
steroid injections, epidural blood patch, trigger point injections, injections into the shoulder, hip,
knee, facet, and sacroiliac joints, and occipital nerve blocks.

Significant anxiety may be an indication for moderate (conscious) sedation or anesthesia services.
In addition, procedures that require the patient to remain motionless for a prolonged period of time
and/or remain in a painful position may require sedation or anesthesia services. Examples of such
procedures include but are not limited to sympathetic blocks (celiac plexus, paravertebral and
hypogastric), chemical or radiofrequency ablation, percutaneous discectomy, trial spinal cord
stimulator lead placement, permanent spinal cord stimulator generator and lead implantation, and
intrathecal pump implantation. Major nerve/plexus blocks are performed less often in the chronic
pain clinic, but the Committee believes that these blocks may more commonly require moderate
(conscious) sedation or anesthesia services (e.g., brachial plexus block, sciatic nerve block, and
continuous catheter techniques).

The Committee recognizes that pediatric patients may require sedation or anesthesia services for
pain procedures because of age-related differences in the approach to this patient population.

Anesthesia services are not the same as moderate (conscious) sedation. For more information, see
the ASA Statements “Distinguishing Monitored Anesthesia Care (“MAC”) from Moderate
Sedation/Analgesia (Conscious Sedation)” and “Continuum of Depth of Sedation; Definition of
General Anesthesia and Levels of Sedation/Analgesia.”

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