Evaluation of Endoscopic Retrograde Cholangiopancreatography Under Conscious Sedation and General Anesthesia

Raymondos, K.; Panning, B; Bachem, I.; Manns, MP; Piepenbrock, S; Meier, P. N.

doi:10.1055/s-2002-33567

Cited by 86 publications

(64 citation statements)

References 9 publications

(23 reference statements)

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“…During general anesthesia, there are issues with the need for muscle relaxants, prolonged extubation time, and instrumentation of the entire airway along with related disadvantages. Under deep sedation, however, problems with airway safety can occur, aspiration risk is increased, and cardiovascular complications can be involved (4).…”

Section: Endoscopic Retrograde Cholangiopancreatography (Ercp)mentioning

confidence: 99%

Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia

Daşkaya

Uysal²,

Çiftçi³

et al. 2016

Turk J Gastroenterol

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Section: Endoscopic Retrograde Cholangiopancreatography (Ercp)mentioning

confidence: 99%

Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia

Daşkaya

Uysal²,

Çiftçi³

et al. 2016

Turk J Gastroenterol

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“…General anesthesia is usually administered during ER CP after prior attempts using conscious sedation have failed [11,12] . A study by Raymondos et al [12] assessed the indications for carrying out ERCP examinations under general anesthesia or conscious sedation.…”

Section: Deciding On the Level Of Sedationmentioning

confidence: 99%

“…A study by Raymondos et al [12] assessed the indications for carrying out ERCP examinations under general anesthesia or conscious sedation. Patients with primary sclerosing cholangitis, liver transplants and those in whom painful dilations were planned received general anesthesia more frequently while conscious sedation was provided more frequently in patients with neoplasms and cholelithiasis.…”

Section: Deciding On the Level Of Sedationmentioning

confidence: 99%

“…For patients in whom ERCP had failed under conscious sedation, a repeated procedure under general anesthesia had a success rate of 83%. A large retrospective analysis from Germany [12] found that painful dilatations were per formed more frequently on patients under general anes thesia and that under conscious sedation the ERCP failure rate was double that of general anesthesia. In another large study from the USA [13] , it was noted that the ove rall complication rate associated with therapeutic inter ventions during ERCP was significantly lower in patients who had received general anesthesia.…”

Section: Deciding On the Level Of Sedationmentioning

confidence: 99%

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Deep sedation for endoscopic retrograde cholangiopacreatography

Chainaki¹

2011

WJGE

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Sedation and analgesia comprise an important element of unpleasant and often prolonged endoscopic retro grade cholangiopacreatography (ERCP), contributing, however, to better patient tolerance and compliance and to the reduction of injuries during the procedure due to inappropriate cooperation. Although most of the studies used a moderate level of sedation, the lite rature has revealed the superiority of deep sedation and general anesthesia in performing ERCP. The anes thesiologist's presence is mandatory in these cases. A moderate sedation level for ERCP seems to be adequate for octogenarians. The sedative agent of choice for sedation in ERCP seems to be propofol due to its fast distribution and fast elimination time without a cumu lative effect after infusion, resulting in shorter recovery time. Its therapeutic spectrum, however, is much nar rower and therefore careful monitoring is much more demanding in order to differentiate between moderate, deep sedation and general anesthesia. Apart from con ventional monitoring, capnography and Bispectral index or Narcotrend monitoring of the level of sedation seem to be useful in titrating sedatives in ERCP.

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“…An additional study indicated that the procedural failure rate in patients undergoing ERCP with sedation was double the failure rate when general anesthesia was utilized (14 vs. 7 %). The higher failure rate with conscious sedation was entirely due to ERCPs that were terminated prematurely (8.5 %) due to inadequate sedation [6]. These data constitute powerful arguments for the use of deep propofol sedation or general anesthesia in patients undergoing ERCP and, indeed, this is the trend in many academic medical centers across the U.S.…”

mentioning

confidence: 98%