Determinants of intravenous conscious sedation for arteriography

PURPOSE: To assess factors that determine the amount of drugs given for intravenous conscious sedation during arteriography, MATERIALS AND METHODS: Data from 254 patients undergoing infradiaphragmatic arteriography at three institutions were evaluated. The effect of age, sex, procedure time, attending physician, and institution on drug use was assessed by analysis of variance and covariance with repeated measures. In a subset of 34 patients, pain and anxiety scores before and after medication were correlated with drug scores. RESULTS: Institution identity and procedure time significantly affected the amount of medication used (both, P = .000), Patient's age and sex, and identity of the physician had no significant effects. While drug use was relatively constant in each institution among different staff physicians, the institutional differences prevailed when the same physicians performed procedures at different institutions. Drug deliveries did not correlate with anxiety and pain scores before or after medication. CONCLUSION: Habits and philosophies of particular institutions, rather than physician guidance or patients' needs, tend to govern the use of intravenous sedatives and analgesics. There is a need for a more patient-oriented standardization of intravenous conscious sedation and analgesia.