I had two ESIs which makes me no expert, but they did use a flouroscope. I know they also offer sedation regardless of the level. Mine was C7/T1 and C6/C7 and neither time did I require sedation.
I'm not sure whether there are types of ESIs that DON'T require a flouroscope - I'm hoping someone else can chime in here and give you some better info. It might be a good idea to look for a new PM.
Good luck.

Kelly