Pain control during office-based procedures in unsedated patients: A cross-specialty review of the literature

Before the use of general anesthesia, medical procedures were performed by necessity in an office setting. As the safety and availability of general anesthetics evolved, many of these procedures were relocated to the operating room to improve patient comfort and outcome. During the past decade, with the aid of technology and the desire for convenience, many interventions have migrated back into the office and are being performed without the use of sedation or general anesthesia. Pain and anxiety control during these procedures are para-mount to patient compliance, accurate diagnosis, and successful treatment. However, methods currently used for pain mitigation and anxiety relief during awake, office-based procedures often lack appropriate evidence and standardization. Here, we review the recent literature on the way in which different specialties achieve analgesia during procedures in this new setting.