Comparative Study of Sedation Protocols for Interventional Radiology Procedures

Abstract

Interventional radiology encompasses procedures ranging from brief image-guided biopsies to multi-hour embolization and ablation cases, and no single sedation protocol serves this heterogeneous caseload equally well. This review compares the major sedation strategies used in interventional radiology suites, including radiologist-directed moderate sedation, monitored anesthesia care, propofol-based deep sedation, and dexmedetomidine-containing regimens, drawing on both interventional radiology-specific studies and analogous comparative data from gastrointestinal endoscopy and electrophysiology. Moderate sedation generally matches monitored anesthesia care on safety while improving procedure-room efficiency for shorter, lower-acuity cases, though this advantage narrows in hemodynamically unstable populations such as those undergoing biliary intervention. Propofol delivered under strict monitoring, whether by anesthesia personnel or trained non-anesthesiologists, remains the most efficient sedative-hypnotic for most cases, while dexmedetomidine has emerged as a useful opioid- and propofol-sparing adjunct for long, low-stimulus procedures despite its slower onset and hemodynamic effects. We conclude that monitoring rigor, staff training, and procedure-specific risk stratification, rather than the choice of a single preferred agent, are what the comparative evidence most consistently ties to safe and efficient sedation outcomes in interventional radiology.