Anesthesia practice and clinical trends in interventional radiology: A European survey

Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends. Methods: A survey was sent to 977 European interventional radiologists to a ssess the use of sedoanalgesia, nursing care, monitoring equipment, pre- an d postprocedural care, and clinical trends in interventional radiology. Pat terns of sedoanalgesia were recorded for both vascular and visceral interve ntional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalge sic drugs and patient care trends were also recorded. A comparison was perf ormed with data derived from a similar survey of interventional practice in the United States. Results: Two hundred and forty-three of 977 radiologists responded (25%). T he total number of procedures analyzed was 210,194. The majority (56%) of d iagnostic and therapeutic vascular procedures were performed at the awake/ alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral intervention al procedures were performed at the drowsy/arousable level of sedation (41% ), 29% were performed at deeper levels of sedation, and 30% at the awake/al ert level. In general, more sedoanalgesia is used in the United States. Eig hty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% r eported the presence of a dedicated recovery area. Forty-nine percent repor ted daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds. Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, proce dures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are used in the United States. Trends toward mak ing interventional radiology a clinical specialty are evident, with 51% of respondents having day case beds, and 30% having inpatient beds.