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Anesthesiology pp 175-188 | Cite as

Anesthesia for ERCP

  • Basavana G. Goudra
  • Preet Mohinder Singh
Chapter

Abstract

With over 500,000 endoscopic retrograde cholangiopancreatography (ERCP) performed every year in the USA alone, the anesthesia aspects warrant a new appraisal. Along with increasing numbers, the complexity of the procedures and morbidity of the patient population has increased. Yet, the anesthesia/sedation methods are poorly standardized and the physio-anatomical factors are not always taken into account. The current review is an attempt to discuss the myriad of variables that need to be understood and applied to provide safe sedation for ERCP. Along with relevant anatomy and physiology of pancreatiocobiliary tree, the systemic effects of ongoing pathology are highlighted. Importance of preoperative evaluation and the specific areas of relevance for safe ERCP sedation are discussed. While planning for the ERCP rooms, due consideration should be given to aspects like type and location of monitoring systems, use of mobile anesthesia carts, type of airway equipment, anesthesia work station and breathing systems. Authors preferred technique and a brief discussion of post procedural sedation issues are mentioned. Table 19.1 provides a summary of anesthesia considerations in patients undergoing ERCP.

Keywords

ERCP Deep sedation Anesthesia Propofol MAC 

Notes

Conflicts of Interest

Funding and Conflicts of interest—none.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hospital University Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  2. 2.Department of AnesthesiaAll India Institute of Medical SciencesNew DelhiIndia

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