Anesthesia for Gastrointestinal Endoscopic Procedures

Goulson, Dave; Fragneto, Regina

doi:10.1016/j.anclin.2008.10.004

Cited by 53 publications

(31 citation statements)

References 47 publications

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“…Indications for these advanced diagnostic and therapeutic techniques are expanding, and patients undergoing ERCP and EUS may have more comorbidities than those receiving esophagogastroduodenoscopy (EGD) and/or colonoscopy[21]. ERCP and EUS procedures can be prolonged, and ERCP is often performed in the prone position, creating a challenge for airway management and ventilation.…”

Section: Introductionmentioning

confidence: 99%

“…ERCP and EUS procedures can be prolonged, and ERCP is often performed in the prone position, creating a challenge for airway management and ventilation. Many practitioners therefore resort to GA with endotracheal intubation[21]. While GA is safely performed in most endoscopy suites, it requires invasive airway management, carries its own risks, prolongs overall procedural time, and may increase costs[22].…”

Section: Introductionmentioning

confidence: 99%

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High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

Schumann¹,

Natov²,

Rocuts-Martinez³

et al. 2016

WJG

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AIMTo examine whether high-flow nasal oxygen (HFNO) availability influences the use of general anesthesia (GA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) and associated outcomes.METHODSIn this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras (era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era (era 2). The primary outcome was the percent utilization of GA vs deep sedation in each period. Secondary outcomes included oxygen saturation nadir during sedation between periods, as well as procedure duration, and anesthesia-only time between periods and for GA vs sedation cases respectively.RESULTSDuring the study period 238 ERCP or EUS cases were identified for analysis. Statistical testing was employed and a P < 0.050 was significant unless the Bonferroni correction for multiple comparisons was used. General anesthesia use was significantly lower in era 2 compared to era 1 with the same trend between era 2 and 3 (P = 0.012 and 0.045 respectively). The oxygen saturation nadir during sedation was significantly higher in era 2 compared to era 3 (P < 0.001) but not between eras 1 and 2 (P = 0.028) or 1 and 3 (P = 0.069). The procedure time within each era was significantly longer under GA compared to deep sedation (P ≤ 0.007) as was the anesthesia-only time (P ≤ 0.001).CONCLUSIONHigh-flow nasal oxygen availability was associated with decreased GA utilization and improved oxygenation for ERCP and EUS during sedation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

Schumann¹,

Natov²,

Rocuts-Martinez³

et al. 2016

WJG

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“…Endoscopic retrograde cholangiopancreatography (ERCP) is usually performed in the prone position under moderate or deep sedation, or under general anaesthesia [1]. Conscious sedation for ERCP has been associated with cardio respiratory complications, particularly drug‐induced respiratory depression and airway obstruction [2–5].…”

mentioning

confidence: 99%

Gastro‐Laryngeal Tube for endoscopic retrograde cholangiopancreatography: a preliminary report*

Gaitini¹,

Lavi²,

Stermer

et al. 2010

Anaesthesia

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Summary The Gastro‐Laryngeal Tube is a modification of the Laryngeal Tube that provides a dedicated channel for the insertion of a gastroscope. In this study of 30 patients undergoing general anaesthesia for endoscopic retrograde cholangiopancreatography, we evaluated both the effectiveness of airway management with a Gastro Laryngeal Tube and the feasibility of performing it using the endoscopic channel. The Gastro Laryngeal Tube was inserted successfully in all patients, in 27 patients at the first attempt. The mean (SD) time to achieve an effective airway was 26 (6) s. Mean (SD) inspiratory and expiratory tidal volumes were 336 (57) ml and 312 (72) ml, respectively, and oropharyngeal leak pressure was 33.7 (2) cmH2O. These data suggest that the Gastro Laryngeal Tube is an effective and secure device for airway management and for use during performance of endoscopic retrograde cholangiopancreatography.

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“…Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and interventional tool in biliary and pancreatic disease. Historically, clinicians have undertaken ERCP under benzodiazepine sedation (BS) 1,2 . However, this is often poorly tolerated.…”

Section: Introductionmentioning

confidence: 99%

“…Historically, clinicians have undertaken ERCP under benzodiazepine sedation (BS). 1,2 However, this is often poorly tolerated. Premature abandonment brought about by patient intolerance of ERCP necessitates repeat attempts or further interventions, including percutaneous transhepatic cholangiography (PTC).…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of benzodiazepine sedation vs. propofol anaesthesia in 252 patients undergoing endoscopic retrograde cholangiopancreatography

Lordan

Woods

Keeling

et al. 2011

HPB

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Anesthesia for Gastrointestinal Endoscopic Procedures

Cited by 53 publications

References 47 publications

High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

Gastro‐Laryngeal Tube for endoscopic retrograde cholangiopancreatography: a preliminary report*

A retrospective analysis of benzodiazepine sedation vs. propofol anaesthesia in 252 patients undergoing endoscopic retrograde cholangiopancreatography

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