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Nonsedation for transforaminal epidural steroid injections linked to low patient dissatisfaction rates

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Among 6,878 transforaminal epidural steroid injections, the frequency of sedation use to perform the procedures was 0.1%, according to a presenter at the International Spine Intervention Society Annual Scientific Meeting.

Survey results from a retrospective audit of 4,418 nonsedated patients showed 81% rated their overall medical care as very good or excellent, study author Felix E. Diehn, MD, of the department of radiology at the Mayo Clinic in Rochester, Minn., said during his presentation.

Clinicians who administer transforaminal epidural steroid injections may avoid using sedation due to its risks, the possibility it will mask an improperly placed needle and other factors, according to Diehn.

The audit was conducted during a 6-year period at a single academic center. The patients, who were treated on an outpatient basis, assessed their satisfaction with the injections by answering a two-question survey 2 weeks post-injection, rating their overall medical care and whether they would refer friends or family members for a similar injection.

“The second principle result, the vasovagal reaction rate, was less than 1% [at] 0.4%,” he said. “On a descriptive basis, those patients who had sedation with their procedures were more commonly male, a little bit younger and more commonly had their cervical segment intervened upon.”

Fifty-three percent of nonsedated patients said they would definitely refer friends or family members, according to Diehn. — by Susan M. Rapp

Reference: Diehn FE. An audit of transforaminal epidural steroid injections without sedation: low patient dissatisfaction and low vasovagal rates. Presented at: International Spine Intervention Society Annual Meeting; July 31-Aug. 3, 2014; Orlando, Fla.

Diehn FE. Pain Med. 2013;doi:10.1111/pme.12092.

Disclosure: Diehn has no relevant financial disclosures.