Intravenous Sedation-Analgesia versus Local Anesthesia for Patient Comfort and Pain Control During Interventional Procedures: A Retrospective Cohort Study

Kaikai Zhang,1,* Guanyu Yang,2,* Liumei Li,2 Jing Sang,2 Jiayao Tian,3 Qinjun Chu,2 Bin Wang1 1Department of Interventional Operating Room, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qinjun Chu, Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Tongbai North Road 16, Zhengzhou, Henan, 450007, People’s Republic of China, Tel +86 13643711142, Email [email protected] Bin Wang, Department of Interventional Operating Room, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Tongbai North Road 16, Zhengzhou, Henan, 450007, People’s Republic of China, Tel +86 13838580733, Email [email protected]: To compare the effects of intravenous sedation‑analgesia (IVSA) versus local anesthesia (LA) on patient‑reported intraoperative comfort and pain control during elective interventional procedures.Methods: This single‑center retrospective cohort study included 1068 adults undergoing interventional procedures between January and March 2024. Patients self‑selected LA or IVSA (midazolam, sufentanil, ketorolac). Propensity score matching (PSM) was applied to balance baseline characteristics. Primary outcomes were patient‑reported comfort and maximum pain scores (0– 10 NRS). Operative time was also compared. After PSM, generalized estimating equation (GEE) models were used to compare outcomes. Sensitivity analyses included ordinal logistic regression and inverse probability weighting.Results: After PSM, 336 patients were included in each group. The mean comfort score was 7.2 ± 1.2 in the IVSA group and 3.5 ± 1.2 in the LA group; the mean pain score was 3.4 ± 1.3 and 7.3 ± 1.2, respectively. Median operative time was 39.5 minutes in the IVSA group and 42.5 minutes in the LA group. GEE analysis showed that IVSA was independently associated with higher comfort scores (β = 3.69, 95% CI: 3.50– 3.88; P < 0.001) and lower pain scores (β = – 3.87, 95% CI: – 4.04 to – 3.70; P < 0.001), with no significant difference in operative time (geometric mean ratio = 0.965, 95% CI: 0.912– 1.020; P = 0.211). Sensitivity analyses yielded consistent results.Conclusion: IVSA was associated with significantly higher intraoperative patient comfort and lower pain scores compared to LA alone, without a significant difference in procedure time, though it was associated with a higher incidence of transient adverse effects.Keywords: conscious sedation, interventional radiology, pain management, patient satisfaction