Anaesthesia for endoscopic retrograde cholangiopancreatography

Kapoor, Hemlata

doi:10.1111/j.1399-6576.2011.02462.x

Cited by 23 publications

(27 citation statements)

References 57 publications

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“…Painless endoscopy will improve the patient's compliance for ERCP and fasten the diagnosis, help treatment of a few biliary pancreatic diseases and help palliation in inoperable cases. [10,11] Bispectral index (BIS) is used to measure the level of sedation. BIS is a reasonable way to monitor the depth of sedation in patients receiving sedation/general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Bispectral Index (Bis) Guided Comparison Between Clinical Effects of Etomidate and Fentanyl Versus Dexmedetomidine and Fentanyl for Conscious Sedation in Ercp Procedure

Das¹,

Bhattacharya²,

Roy³

et al. 2019

jemds

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BACKGROUND Endoscopic retrograde cholangiopancreatogram (ERCP) is recently being done under conscious sedation using intravenous anaesthetic agent and fentanyl. Dexmedetomidine, a new alpha 2 agonist with analgesic and sedative effects, is now being used to induce conscious sedation.The aim of this study was to compare BIS-guided time of onset of conscious sedation and recovery profile, haemodynamic effects, physician/ patient satisfaction score and adverse events if any between patients receiving either etomidate-fentanyl or dexmedetomidine-fentanyl combination for undergoing ERCP procedure. MATERIALS AND METHODSThis is a randomised controlled trial. One hundred patients scheduled for ERCP under BIS-guided conscious sedation were randomly allocated into two equal groups to receive either etomidate-fentanyl (Group E) or dexmedetomidine-fentanyl (Group-D). After premedication with midazolam (0.05 mg/kg), glycopyrrolate (0.2 mg) and fentanyl (1 mcg/kg), etomidate or dexmedetomidine were given to the patients allocated to the respective groups to attain a BIS score of 70. Sedation was maintained throughout the procedure by continuous infusion of these drugs. The time of onset and recovery from sedation, haemodynamic effects, physicians and patient's satisfaction scores, pre-and post-operative serum cortisol and any adverse events were noted in the two groups. RESULTSThe time of onset and recovery was earlier in E group (p=0.001) Incidence of myoclonus was significantly higher in E group (p=0.022). There was higher incidence of hypertension in D group (p=0.012). Physician and patient satisfaction were comparable in both the groups. There was no difference in pre-op and 12-hour post-op serum cortisol in either group. CONCLUSIONBIS-guided etomidate-fentanyl for ERCP resulted in earlier onset and recovery from sedation with stable haemodynamics compared with dexmedetomidine-fentanyl.

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Section: Discussionmentioning

confidence: 99%

Bispectral Index (Bis) Guided Comparison Between Clinical Effects of Etomidate and Fentanyl Versus Dexmedetomidine and Fentanyl for Conscious Sedation in Ercp Procedure

Das¹,

Bhattacharya²,

Roy³

et al. 2019

jemds

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show abstract

“…[2] Excellent reviews are available on the anesthetic management of patients presenting for ERCP. [8] The choice of the airway is debatable. [6] In a recent retrospective analysis of 653 procedures, incidence of hypoxemia was reduced to insignificant levels with an improvized airway management.…”

Section: Discussionmentioning

confidence: 99%

Goudra ventilating bite block to reduce hypoxemia during endoscopic retrograde cholangiopancreatography

Goudra¹,

Chandramouli

Singh

et al. 2014

Saudi J Anaesth

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“…The patient category scheduled for ERCP procedures are usually the elderly, as the incidence of biliary complications is more frequent in the older age groups, who could be complaining of some co-morbid diseases adding additional risks to the procedure [1,2]. So cautious choice of a sedative agent, as well as monitoring of its hemodynamic effects are required.…”

Section: Introductionmentioning

confidence: 99%

“…It is a complex painful procedure that necessitates adequate sedation and analgesia, as agitation and discomfort have been reported to be within the factors causing post ERCP complications [1].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Dexmedetomidine as an Adjunct Agent for Sedation during ERCP

Mahmoud¹,

Hasanin²,

Abdel-Razek³

2016

J Anesth Clin Res

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Objectives: To evaluate dexmedetomidine as an adjunct drug to propofol for sedation during ERCP, and its effects on perfusion index (PI) which could be used as an indicator for analgesia level.Methods: 76 patients ASA (I-III) scheduled for ERCP procedure were randomly classified to either dexmedetomidine/propofol group or propofol group. In dexmedetomidine/propofol group, sedation was induced by dexmedetomidine (0.7 µg/kg) and propofol (50 mg) followed by infusion of dexmedetomidine (0.4 µg/kg/h) and propofol (0.5-1 mg/kg/h). In propofol group, sedation was induced by propofol (50 mg) followed by propofol infusion (0.5-1 mg/kg/h). HR, SBP, DBP, RR, SPO2 and PI were continuously monitored and recorded at the time points (T0 to T8). Results:Comparing dexmedetomidine/propofol group versus propofol group; PI values showed significant increase at T2 to T7 (p˂0.001), HR values showed significant decrease at T1 to T8 (p 0.013 at T1 and 0.001 at T2 to T8), SBP values showed significant decrease at T1 to T8 (p=0.002 at T1, 0.001 at T2 to T7 and 0.004 at T8) and DBP values showed significant decrease at T4 to T6 (p value 0.008, 0.002 and 0.003 at T4.T5 and T6). RR and SPO 2 values were comparable in both groups. In dexmedetomidine/propofol group, the propofol dosage was significantly lower (p value 0.001) and the recovery time was significantly higher (p value 0.001) than that of propofol group, while the procedure time was comparable between both groups. Dexmedetomidine/propofol group showed higher incidence of bradycardia than propofol group (p value 0.035) while propofol group showed more cases with tachycardia (p value 0.016) and more cases with airway obstruction (p value 0.026).Conclusion: dexmedetomidine is a useful adjunct drug for sedation during ERCP procedure.

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Anaesthesia for endoscopic retrograde cholangiopancreatography

Cited by 23 publications

References 57 publications

Bispectral Index (Bis) Guided Comparison Between Clinical Effects of Etomidate and Fentanyl Versus Dexmedetomidine and Fentanyl for Conscious Sedation in Ercp Procedure

Bispectral Index (Bis) Guided Comparison Between Clinical Effects of Etomidate and Fentanyl Versus Dexmedetomidine and Fentanyl for Conscious Sedation in Ercp Procedure

Goudra ventilating bite block to reduce hypoxemia during endoscopic retrograde cholangiopancreatography

Effectiveness of Dexmedetomidine as an Adjunct Agent for Sedation during ERCP

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