The safety of deep sedation with propofol controlled by the endoscopist in endoscopic retrograde cholangiopancreatography (ERCP): a prospective study in a tertiary hospital

Solanas, Lara Luzón; Domenche, Leticia Ollero; Moros, Eva María Sierra; Pérez, José Val; Teodoro, María Teresa Soria San; Júlvez, Teresa Giménez; Amézaga, Rafael Uribarrena

doi:10.17235/reed.2018.5262/2017

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…It is therefore obvious that adequate sedation improves the outcome of the ERCP procedure. [ 60 ] There remains controversy[ 61 ] and a huge variance in national and international legislations[ 62 ] as to whether propofol should be administered only by anesthetists or whether properly trained nonanesthetists[ 63 ] can apply propofol sedation safely. Nurse-administered,[ 64 ] patient-controlled,[ 65 ] or computer-assisted, target-controlled infusions are alternative means of delivering propofol sedation during endoscopy with prolonged procedure times or complex interventions.…”

Section: Sedation In Ercp Do We Need An Anesthetist To Provide Sedati...mentioning

confidence: 99%

Controversies in ERCP: Indications and preparation

et al. 2022

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The aim of the series of papers on controversies of biliopancreatic drainage procedures is to discuss the pros and cons of the varying clinical practices and techniques in ERCP and EUS for drainage of biliary and pancreatic ducts. The first part focuses on indications, clinical and imaging prerequisites before ERCP, sedation options, post-ERCP pancreatitis (PEP) prophylaxis, and other related technical topics. In the second part, specific procedural ERCP-techniques including precut techniques and its timing as well as management algorithms are discussed. In addition, controversies in EUS-guided bile duct and pancreatic drainage procedures are under preparation.

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Section: Sedation In Ercp Do We Need An Anesthetist To Provide Sedati...mentioning

confidence: 99%

Controversies in ERCP: Indications and preparation

et al. 2022

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“…Regarding ERCP, propofol sedation is safe (13,14), leading to shorter recovery time without an increase of cardiopulmonary side effects (15), and similar cannulation rates (16). The current observational prospective study by Luzón Solanas et al (17), published in this issue, assesses the safety of endoscopist-directed nurse-administered propofol-based sedation in 661 patients who underwent an ERCP. Overall, they concluded an adverse event rate of 9.6%, according to previously published data (18).…”

mentioning

confidence: 93%

Enhancing the current evidence on endoscopist-directed propofol-based sedation

Pérez-Cuadrado-Robles

Ferreira

García-Cano

2018

Rev Esp Enferm Dig

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During the last years, there is more and more scientific evidence about the safety and feasibility of non-anesthesiologist administration of propofol (NAAP) in gastrointestinal endoscopy, reducing sedation induction and recovery time as well as increasing patient and endoscopist satisfaction. Furthermore, a similar risk of adverse events compared with traditional agents or anesthesiologist administration of propofol (AAP) has been described. The present special issue of the Spanish Journal of Gastroenterology (Revista Española de Enfermedades Digestivas) focusses on NAAP in different settings, including complex endoscopic procedures.

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“…EUS‐GBD is not only an effective treatment for acute cholecystitis but can also provide definitive therapy as it reduces the risk of relapsing biliary events in patients not undergoing cholecystectomy . As most of these patients present an elevated sedation‐related adverse event risk, combining ERCP with EUS‐GBD in a single procedure instead of two separate ones could be beneficial. Feasibility of combining ERCP with other endoscopic procedures such as EUS (for tumor staging, for diagnosis of choledocholithiasis, or for rendezvous following failed cannulation) duodenal stenting or cholangioscopy has recently been shown, but there is virtually no published evidence supporting this combined approach to gallstone disease.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

Yuste

García‐Alonso

Sánchez-Ocaña

et al. 2019

Digestive Endoscopy

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Background and Aim: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an emerging option for acute cholecystitis in non-surgical candidates. Combining endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stones with EUS-GBD in a single session might become a non-surgical management strategy to comprehensively treat gallstone disease in selected patients. Methods:Single-center retrospective cohort study comparing outcomes between EUS-GBD alone (group A) and single-session ERCP combined with EUS-GBD (group B). Consecutive patients who underwent EUS-GBD with a lumen-apposing metal stent (LAMS) between June 2011 and August 2018 were analyzed. Exclusion criteria were subjects included in randomized clinical trials, patients who had had ERCP within 5 days of EUS-GBD, patients in whom ERCP or EUS-GBD was carried out for salvage of one or the other procedure, and patients who underwent concurrent EUS-guided biliary drainage. Results: One hundred and nine consecutive patients under-went EUS-GBD with LAMS during the study period. Seventy-one patients satisfied the inclusion criteria and 34 patients were in group A and 37 in group B. Baseline characteristics were similar in both groups. There were no significant differences in technical (97.1% vs 97.3%; P = 0.19) and clinical success rates (88.2% vs 94.6%; P = 0.42) of EUS-GBD in group A versus group B. Rate of adverse events was similar in both groups, five (14.7%) in group A versus five (13.5%) in group B. Conclusions:Single-session EUS-GBD combined with ERCP has comparable rates of technical and clinical success to EUS-GBD alone. A combined EUS-GBD and ERCP procedure does not appear to increase adverse events and makes possible comprehensive treatment of gallstone disease by purely endoscopic means.

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The safety of deep sedation with propofol controlled by the endoscopist in endoscopic retrograde cholangiopancreatography (ERCP): a prospective study in a tertiary hospital

Abstract: deep sedation with propofol controlled by trained endoscopy staff is a safe method in complex endoscopic procedures such as ERCP.

Cited by 7 publications

References 18 publications

Controversies in ERCP: Indications and preparation

Controversies in ERCP: Indications and preparation

Enhancing the current evidence on endoscopist-directed propofol-based sedation

Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

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