Anesthesia for endoscopic retrograde cholangio-pancreatography (ERCP) from 1999-2003 in Siriraj Hospital: A retrospective study

Abstract

Background: Endoscopic retrograde cholangio-pancreatography (ERCP) is another treatment option for hepato-biliary tract abnormalities. The authors studied anesthetic data as a basis for further research. Method: Retrospectively analyzed the patients on whom ERCP had been performed during the period of January, 1999 to November, 2003 in Siriraj Hospital, The patients' characteristics, preanesthetic problems, anesthetic techniques, anesthetic agents, anesthetic time, ERCP procedure and complications were assessed. Results: There were 2,144 patients who received the procedure during study period. The age group of 50-69 years was the highest one (46.9%). Most patients had ASA class II (54.7%). The diagnosis were stone (40.3%), tumor (34.0%), hepato-biliary tract infection (8.1%) and others (17.6%). Hypertension, diabetes mellitus and hematologic diseases were the most common preanesthetic problems. Total intravenous anesthesia (TIVA) was the anesthetic technique mainly employed (96.4%). Anesthetic agents were mainly administered with propofol, midazolam and fentanyl. The mean anesthetic time was 40.0 ± 18.5 minutes. The indications for ERCP procedures were diagnostic (18.9%), stone removal (37.1%), stent removal and/or insertion (35.3%) and others (8.7%). The most frequent anesthetic complication was hypotension. Conclusion: During anesthetic management for ERCP, special techniques or drugs in anesthesia are not routinely required, however, the anesthetic personnel had to optimize the patient's condition for safety and there should be an awareness of complications.