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Anesthesia for PAE

What type of sedation or anesthesia is used for PAE?

Making patients comfortable during prostate artery embolization, or PAE is one of the keys to successfully performing it in an outpatient setting. In our Austin interventional radiology suite, we are fortunate to offer deep sedation for almost all the patients who undergo PAE. Because prostate embolization is not painful, patients sleep through the entire procedure under deep sedation. Below, we go through the three main anesthesia options for PAE.

Deep sedation

Deep sedation is the most common type of anesthesia we chose for prostate artery embolization. As we mentioned, prostate artery embolization is virtually painless. However, it does require patients to lie on the table for over an hour while we set up a sterile field and perform the embolization. Out of our options, deep sedation is best at keeping patients perfectly still. Because the prostate arteries are tiny, small movements can change their orientation, forcing us to remap pelvic arteries with additional x-ray dye studies. With deep sedation, you are asleep but still breathing on your own, so no breathing tube is necessary. The most common drug we use for this is propofol, which gets patients asleep quickly and does not hang around their system for very long after we are finished.

Moderate or conscious sedation

Moderate sedation, also known as conscious sedation, is lighter than deep sedation. With this type of anesthesia, patients can respond to questions during the procedure but are still significantly sedated. Many will not remember most of the procedure. This has been called “twilight” sedation when being explained to patients. With this type of anesthesia, the blood pressure and breathing are less suppressed, and it can be useful for people with heart and lung issues, making them less ideal candidates for deep sedation. The typical moderate sedation medications are fentanyl and versed. In particular, the versed can take the better part of a day to fully wear off.

Minimal sedation and local anesthesia for PAE

This is the lowest level of anesthesia. With this type of sedation, patients are relaxed but awake during the procedure. Some patients elect to only have local anesthesia for the femoral artery catheter placement, which is the only uncomfortable part. PAE with local anesthesia is often doable as long as patients are able to comfortably stay still on our procedure table.

If you would like more information regarding prostate artery embolization and want to speak with our interventional radiologist in Austin, Texas, please contact us. We have safely performed hundreds of procedures on patients using all varieties of sedation.

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