When people have sedation from or under the direction of an anesthesiologist for procedures outside of an operating room, they’re more likely to go home instead of head to a long-term care community, according to a new study.
The report was presented on Saturday at the Anesthesiology 2023 annual meeting.
The authors compared what happened to people after being discharged from a hospital after they got sedation administered by an anesthesiologist, or by a nurse anesthetist under the direction of an anesthesiologist. They compared it to people who received sedation from another type of doctor.
Procedures that require anesthesia outside of an operating room can include catheter placement in a vein, angiograms (X-rays of blood vessels) and image-guided biopsies. Instead of an operating room, these procedures are handled in an interventional radiology (IR) suite. One in every 10 people admitted to the hospital needs an IR procedure. Many of them have a higher risk for complications because of existing health issues or the need for complex procedures.
The study looked at data from 9,682 people who had sedation in an IR suite. Of them, 16.93% went from the hospital to a long-term care facility, such as a nursing home, due to complications. And of the 16.93% of people who weren’t discharged home, 87% had sedation administered or directed by a doctor who wasn’t an anesthesiologist, often with the assistance of a nurse. Only 13% of those people had sedation administered or directed by an anesthesiologist.
“We focused on patients undergoing IR procedures as they often have health issues such as heart disease or diabetes and some of the procedures are high risk,” Matthias Eikermann, MD, PhD, senior author of the study and chair of the department of anesthesiology at Montefiore Medical Center, Bronx, New York, said in a statement.
“The anesthesiologist is not just providing sedation, but life support for the patient during the entire procedure,” Eikermann said. “The difference in outcomes is because anesthesiologists are trained to identify early complications and treat them immediately. Physicians who are not anesthesiologists are not trained to do that.”
Anesthesiologists administered or directed sedation for higher-risk people, such as those with more invasive procedures or more health issues. Despite their high risk, the people who received sedation from or directed by an anesthesiologist were nearly 70% more likely to go home compared to those who had sedation administered or directed by a doctor who wasn’t an anesthesiologist.
“Patients should know that they can ask for an anesthesiologist if they are concerned about excessive pain, anxiety or their safety during diagnostic procedures,” Eikermann said. “Our research suggests rethinking anesthesia assignments to ensure anesthesiologists provide sedation when patients are at higher risk due to their health or are having more complex, longer or more-invasive procedures.”
