Types of anesthesia for different sacroiliac joint interventions

There are a variety of anesthetic techniques commonly used for sacroiliac joint (SIJ) procedures. For example, diagnostic SIJ injections do not necessitate anesthesia, while open SIJ fusions require general anesthesia. This chapter, targeted to practitioners performing SIJ procedures, covers the basic elements of these techniques. After a brief discussion of the history of anesthesia in relation to SIJ procedures, each common anesthetic technique is discussed, in order of increasing sedation. Local anesthesia is discussed for intraarticular joint injections, blocks of the nerves innervating the SIJ, and radiofrequency ablations of these same nerves. Monitored anesthesia care is discussed for procedures such as minimally invasive SIJ fusions and the Simplicity radiofrequency ablation technique. The use of neuraxial anesthesia, via either spinal or epidural blocks, is considered for lateral SIJ fusions. Finally, the use of general anesthesia for lateral and open fusions is reviewed.