721 - Breathe Easy: The Use of Ketamine for Moderate Sedation During Interventional Radiology Procedures

Monday, April 13, 2026

4:51 PM - 4:57 PM ET

Abstract Presenter(s)

MH

Marie Hamel, BS

Medical Student
The Warren Alpert Medical School of Brown University, United States

Author/Co-author(s)

SA

Sun-Ho Ahn, MD, FSIR

Interventional Radiologist
Warren Alpert Medical School of Brown University, United States

Learning Objectives:

Conceptualize the benefits and drawbacks of using ketamine for sedation during interventional radiology (IR) procedures.

Identify patients who may be more suited for ketamine sedation.

Background: For the majority of IR procedures, moderate sedation is utilized to provide adequate sedation and analgesia without the need for an anesthesiologist's supervision {1}. This allows for resource-efficient procedures that reduce possible risks to the patient when compared to deep sedation and general anesthesia {2}. Commonly, moderate sedation is achieved using both a benzodiazepine for sedation and an opioid for analgesia; for example, midazolam and fentanyl are a common combination {3}. There is a recent movement to investigate the use of ketamine in place of fentanyl for sedation to improve patient outcomes and reduce adverse events {4}.

Clinical Findings/Procedure Details: Recent findings demonstrate that the use of ketamine results in higher levels of intraoperative and postoperative adequate pain control for patients and increased patient satisfaction without increasing procedure duration or adverse events {4, 6}. The use of ketamine does not necessitate anesthesiology supervision, preserving resources and optimizing workflow. Since ketamine does not cause respiratory depression, the two most common adverse effects of sedation with fentanyl - apnea (60.2%) and hypoxemia (42.2%) - can be avoided {1}. This is specifically advantageous for patients with attributes that put them at higher risk for hypoxemia during sedation, such as advanced age {5}. A study by Greco et al. found that 82% of surveyed interventional radiologists preferred using ketamine for sedation {4}. Disadvantages of using ketamine include increased risk of hypertension and theoretical risk of emergence delirium, which was not commonly documented as an adverse effect when used for procedural sedation {7}.

Conclusion and/or Teaching Points: Emerging research suggests that using ketamine in place of opioids like fentanyl provides an advantage in terms of pain control and avoidance of respiratory depression without increasing procedure time or introducing additional adverse events.