Clinical efficacy of deep sedation for endoscopic retrograde cholangiopancreatography: A comparison between clinical assessment and NarcotrendTM monitoring

S. Amornyotin, W. Srikureja, W. Chalayonnavin, S. Kongphlay
  • European Journal of Anaesthesiology, June 2011, Wolters Kluwer Health
  • DOI: 10.1097/00003643-201106001-00093

Clinical efficacy of deep sedation for ERCP: clinical assessment VS NarcotrendTM monitoring

What is it about?

Moderate to deep sedation is generally used for endoscopic retrograde cholangiopancreatography (ERCP). The depth of sedation is usually judged by clinical assessment and EEG-guided monitoring. The aim of this study was to compare the clinical efficacy of clinical assessment and Narcotrend™ monitoring during sedated ERCP.

Why is it important?

All endoscopies were completed successfully. Mean total dose of propofol in group C was significantly lower than in group N. However, the mean dose of propofol, expressed as dose/kg or dose/kg/hr in both groups, was not significantly different (p=0.400, 0.227). Recovery time, patient tolerance and satisfaction, and endoscopist satisfaction was comparable among the two groups. Sedation- related adverse events during and immediately after the procedure, such as hypotension, hypertension, tachycardia, bradycardia, transient hypoxia, or upper airway obstruction in group C (62.2%), were significantly higher than in group N (37.5%) (p=0.006).

Perspectives

Somchai Amornyotin
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University

Clinical assessment and Narcotrend-guided sedation using propofol for deep sedation demonstrated comparable propofol dose and recovery time. Both monitorings were equally safe and effective. However, the Narcotrend-guided sedation showed lower hemodynamic changes and complications as compare to the clinical assessment-guided sedation.

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http://dx.doi.org/10.1097/00003643-201106001-00093

The following have contributed to this page: Somchai Amornyotin