What should interventional radiologists know about the use of local anesthetics, sedatives, and local analgesics? Narrative review of the literature

Interventional radiology has emerged as a key specialty for performing minimally invasive procedures. In this context, the appropriate use of local anesthetics, sedation, and analgesia is essential to improve patient comfort, safety, and outcomes. This narrative literature review explores the clinical use of local anesthetics, sedatives, and analgesics within interventional radiology, with a focus on indications, pharmacological considerations, risks, and practical recommendations for radiologists. While pharmacological principles are briefly addressed, the main focus lies on safe administration protocols, patient monitoring, and drug selection based on procedure type and patient condition. The article discusses common complications such as local anesthetic systemic toxicity, respiratory depression, and adverse events associated with opioids and benzodiazepines. The review is based on international guidelines (ASA, SIR, CIRSE) and aims to provide clear strategies to enhance patient safety and procedural success. Ultimately, this article serves as a practical guide for interventional radiologists seeking to optimize sedation and analgesia practices in daily clinical settings, in line with current safety and ethical standards.