Deep Sedation or General Anesthesia for ERCP?
Ideal sedation for endoscopic procedures should maximize patient comfort and safety. However, during many endoscopic procedures performed under conscious (i.e., moderate) sedation, patient comfort is compromised to some extent in the interest of safety. Although conscious sedation was the mainstay for most endoscopic procedures over the initial decades of endoscopy, anesthesia services have increasingly been utilized over recent years to provide deeper levels of sedation . The key driver for increased anesthesia utilization over the last decade has been the need to improve patient comfort, satisfaction, and safety while simultaneously improving the efficiency of endoscopy units. A significant facilitating factor has been the introduction and availability of new pharmaceutical agents such as propofol, which allow rapid induction of deep sedation while also enabling rapid recovery . Propofol sedation for gastroscopy and colonoscopy is as safe as sedation using traditional agents, w
- Inadomi JM, Gunnarsson CL, Rizzo JA, Fang H. Projected increased growth rate of anesthesia professional-delivered sedation for colonoscopy and EGD in the United States: 2009 to 2015 Gastrointest Endosc. 2010;72:580–586.
- Cohen LB, Wecsler JS, Gaetano JN, et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol.. 2006;101:967–974. CrossRef
- Rex DK, Deenadayalu VP, Eid E, et al. Endoscopist-directed administration of propofol: a worldwide safety experience. Gastroenterology.. 2009;137:1229–1237. CrossRef
- Wang D, Chen C, Chen J, et al. The use of propofol as a sedative agent in gastrointestinal endoscopy: a meta-analysis. PLoS ONE.. 2013;8:e53311. CrossRef
- Jeurnink SM, Steyerberg E, Kuipers E, Siersema P. The burden of endoscopic retrograde cholangiopancreatography (ERCP) performed with the patient under conscious sedation. Surg Endosc.. 2012;26:2213–2219. CrossRef
- Raymondos K, Panning B, Bachem I, Manns MP, Piepenbrock S, Meier PN. Evaluation of endoscopic retrograde cholangiopancreatography under conscious sedation and general anesthesia. Endoscopy.. 2002;34:721–726. CrossRef
- Garewal D, Powell S, Milan SJ, Nordmeyer J, Waikar P. Sedative techniques for endoscopic retrograde cholangiopancreatography Cochrane Database Syst Rev. 2012;6:CD007274.
- Cook T, Behringer EC, Benger J. Airway management outside the operating room: hazardous and incompletely studied. Curr Opin Anaesthesiol.. 2012;25:461–469. CrossRef
- Barnett SR, Berzin T, Sankara S et al. Deep Sedation without intubation for ERCP is appropriate in healthy, non-obese patients. Dig Dis Sci (Epub ahead of print). doi:10.1007/s10620-013-2783-x.
- Goudra BG, Singh PM, Sinha AC. Anesthesia for ERCP: impact of anesthesiologist’s experience on outcome and cost. Anesthesiol Res Pract.. 2013;2013:570518.
- Garewal D, Vele L, Waikar P. Anaesthetic considerations for endoscopic retrograde cholangio-pancreatography procedures. Curr Opin Anaesthesiol.. 2013;26:475–480. CrossRef
- Cotton PB, Eisen G, Romagnuolo J, et al. Grading the complexity of endoscopic procedures: results of an ASGE working party. Gastrointest Endosc.. 2011;73:868–874. CrossRef
- Deep Sedation or General Anesthesia for ERCP?
Digestive Diseases and Sciences
Volume 58, Issue 11 , pp 3061-3063
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Industry Sectors