Safety and sedation-associated adverse event reporting among patients undergoing endoscopic cholangiopancreatography: a comparative systematic review and meta-analysis

McCarty, Thomas R.; Hathorn, Kelly; Creighton, David; Alsamman, Mohd Amer; Thompson, Christopher C.

doi:10.1007/s00464-020-08210-2

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…In recent years, endoscopic retrograde cholangiopancreatography (ERCP) has become an indispensable minimally invasive intervention for the diagnosis and treatment of biliary and pancreatic diseases 1 . However, it is complex and takes a long time for diagnosis and treatment, which leads to huge challenges in terms of surgeries 2 . At present, ERCP is mostly performed under intravenous anesthesia, which helps maintain spontaneous breathing in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…Patients are usually placed in the prone position or semiprone position. This integration may cause hemodynamic and physiological changes in lung ventilation and may increase the difficulty of respiratory tract management during the operation 2–4 . Therefore, we need to select an anesthetic that has the least influence on respiratory cycles.…”

Section: Introductionmentioning

confidence: 99%

“… 1 However, it is complex and takes a long time for diagnosis and treatment, which leads to huge challenges in terms of surgeries. 2 At present, ERCP is mostly performed under intravenous anesthesia, which helps maintain spontaneous breathing in clinical practice. Patients are usually placed in the prone position or semiprone position.…”

Section: Introductionmentioning

confidence: 99%

“…This integration may cause hemodynamic and physiological changes in lung ventilation and may increase the difficulty of respiratory tract management during the operation. 2 , 3 , 4 Therefore, we need to select an anesthetic that has the least influence on respiratory cycles. Remimazolam besylate is a new type of ultrashort‐acting benzodiazepine.…”

Section: Introductionmentioning

confidence: 99%

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The effective doses of remimazolam besylate in the procedural sedation of endoscopic retrograde cholangiopancreatography

Tan

et al. 2022

Ibrain

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This study aimed to determine the values of the half‐effective dose (ED50) and 95% effective dose (ED95) of remimazolam besylate used in the procedural sedation of endoscopic retrograde cholangiopancreatography (ERCP). Sixty patients who fulfilled the inclusion and exclusion criteria of this study were selected. Sufentanil was administered intravenously and remimazolam besylate was administered 2 min later. ERCP treatment was feasible when the modified alertness/sedation (MOAA/S) score was ≤2. If choking or movement occurred during duodenoscope placement, it was considered as a positive reaction. The dose was increased in the next patient; otherwise, it was considered as a negative reaction, and the dose was reduced in the next patient. The ED50 and ED95 values and 95% confidence interval (CI) of remimazolam besylate were calculated by Probit regression analysis. All 60 patients completed the trial. The ED50 and ED95 values of remimazolam besylate were 0.196 and 0.239 mg/kg, respectively, for the procedural sedation of ERCP. The time of MOAA/S score ≤ 2 was (82.58 ± 21.70) s, and the mean time of awakening was (9.03 ± 5.64) min. Transient hypotension was observed in two patients without medical intervention. The ED50 and ED95 values of remimazolam besylate used in the procedural sedation of ERCP were 0.196 and 0.239 mg/kg, and the dose of the medications has definite efficacy and good safety.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effective doses of remimazolam besylate in the procedural sedation of endoscopic retrograde cholangiopancreatography

Tan

et al. 2022

Ibrain

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“…However, the risk increases when intravenous administration is done through small-calibre veins. Venous wall pain and swelling might develop following the administration of some propofol preparations, and lidocaine can effectively intervene against it [ 16 , 23 , 25 , 27 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

Up-to-date literature review and issues of sedation during digestive endoscopy.

Liu¹,

Zhang²

2023

Videosurgery and Other Miniinvasive Techniques

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Sedation is common during digestive endoscopy to provide comfort and pain relief for patients. However, the use of sedation in endoscopy also poses potential risks, and recent issues have been raised regarding its safety and administration. This literature review paper will discuss the most recent developments in the field of sedation in digestive endoscopy, including the adverse events that might be associated with sedation and how to manage it, the legal issues associated with administration, the impact of COVID-19 on sedation practices, and sedation in special situations. It will also touch upon the current guidelines and recommendations for sedation, including the importance of patient selection and monitoring and the need for training and certification for endoscopists administering sedation. The review will also analyse studies evaluating the safety and efficacy of various sedation techniques, including propofol, midazolam, and others. It will examine the benefits and drawbacks of these agents.

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