Background: Transforaminal epidural steroid injection (TFESI) can be administered with or without
sedation in clinical practice.
Objectives: The aim of this study was to compare both procedures in terms of patient and physician
satisfaction, preoperative anxiety level, procedural pain level, and complications.
Study Design: A prospective randomized trial.
Setting: A university hospital interventional pain management center.
Methods: The study included patients scheduled for single-level unilateral TFESI. The patients
were randomized into 2 groups. The first group underwent TFESI without sedation, whereas the
second group underwent TFESI with sedation. The Likert scale was used to determine the patient and
physician satisfaction, and the Numeric Rating Scale (NRS-11) was used to determine the procedural
pain level. Cases in which the procedure was to be repeated, the patient was questioned if they
desired to undergo the procedure with the same technique.
Results: A total of 64 patients, (31 [48.4%] in the sedation group) were included. In the sedation
group, the patient and physician satisfaction were significantly higher (P = 0.0001), the periprocedural
NRS-11 scores were significantly lower (P = 0.0001), and the rate of desire to have the intervention
with the same technique was higher (P = 0.001). After the regression analysis, we reported that there
was a significant correlation between being in the sedation group and NRS-11 procedure scores, the
desire to have the same technique, and patient and physician satisfaction (odds ratio [OR], 0.341;
OR, 0.648; OR, 0.329; OR, 0.514; P = 0.0001).
Limitations: Both patients and physicians were unblinded.
Conclusions: Coadministration of TFESI with sedation improves patient and physician satisfaction.
Additionally, the low periprocedural pain level results in patients’ demand for the intervention to be
performed with sedation in the event of repetition of the procedure.
Key words: Patient satisfaction, transforaminal epidural steroid injection, sedation, physician
satisfaction
Re: Does Coadministration of Transforaminal
Epidural Steroid Injection with Sedation Improve
Patient Satisfaction?