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Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience
BACKGROUND AND STUDY AIM: Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde c...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009548/ https://www.ncbi.nlm.nih.gov/pubmed/35431757 http://dx.doi.org/10.4103/sja.sja_714_21 |
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author | Melis, Valentina Aldo, Cristalli Dioscoridi, Lorenzo Arlati, Sergio Molinari, Pietro Cintolo, Marcello Pugliese, Francesco Bonato, Giulia Forti, Edoardo Massimiliano, Mutignani |
author_facet | Melis, Valentina Aldo, Cristalli Dioscoridi, Lorenzo Arlati, Sergio Molinari, Pietro Cintolo, Marcello Pugliese, Francesco Bonato, Giulia Forti, Edoardo Massimiliano, Mutignani |
author_sort | Melis, Valentina |
collection | PubMed |
description | BACKGROUND AND STUDY AIM: Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral center for digestive endoscopy. PATIENTS AND METHODS: Anesthesiological records, anamnestic, and intraoperative data of patients who underwent advanced therapeutic biliopancreatic endoscopies at our tertiary referral center from January 2019 until January 2020 were collected in the present observational study. RESULTS: One hundred fifty-three patients (93 M; median age: 68-year-old; mean ASA status: 2) were considered eligible for a procedure in the prone position with GA in spontaneous breathing. Prone position was always the initial setting. Propofol administration through a target-controlled infusion (TCI) pump was the choice to achieve GA. In our experience, desaturation appears to be the most frequent adverse event, accounting for 35% of cases (55/153). Treatment foresaw additional oxygen through a nasopharyngeal catheter, which proved to be a sufficient measure in almost all patients (52/55). Other adverse events (i.e., inadequate sedative plan, pain, and bradycardia) accounted for 2.6% of cases (4/153). CONCLUSIONS: Non-intubated GA in the prone position may be regarded as a safe procedure, as long as the anesthesiological criteria of exclusion are respected and the anesthesiological team has become acquainted with the peculiar NORA setting and familiar with the management of possible adverse events. |
format | Online Article Text |
id | pubmed-9009548 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-90095482022-04-15 Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience Melis, Valentina Aldo, Cristalli Dioscoridi, Lorenzo Arlati, Sergio Molinari, Pietro Cintolo, Marcello Pugliese, Francesco Bonato, Giulia Forti, Edoardo Massimiliano, Mutignani Saudi J Anaesth Original Article BACKGROUND AND STUDY AIM: Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral center for digestive endoscopy. PATIENTS AND METHODS: Anesthesiological records, anamnestic, and intraoperative data of patients who underwent advanced therapeutic biliopancreatic endoscopies at our tertiary referral center from January 2019 until January 2020 were collected in the present observational study. RESULTS: One hundred fifty-three patients (93 M; median age: 68-year-old; mean ASA status: 2) were considered eligible for a procedure in the prone position with GA in spontaneous breathing. Prone position was always the initial setting. Propofol administration through a target-controlled infusion (TCI) pump was the choice to achieve GA. In our experience, desaturation appears to be the most frequent adverse event, accounting for 35% of cases (55/153). Treatment foresaw additional oxygen through a nasopharyngeal catheter, which proved to be a sufficient measure in almost all patients (52/55). Other adverse events (i.e., inadequate sedative plan, pain, and bradycardia) accounted for 2.6% of cases (4/153). CONCLUSIONS: Non-intubated GA in the prone position may be regarded as a safe procedure, as long as the anesthesiological criteria of exclusion are respected and the anesthesiological team has become acquainted with the peculiar NORA setting and familiar with the management of possible adverse events. Wolters Kluwer - Medknow 2022 2022-03-17 /pmc/articles/PMC9009548/ /pubmed/35431757 http://dx.doi.org/10.4103/sja.sja_714_21 Text en Copyright: © 2022 Saudi Journal of Anesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Melis, Valentina Aldo, Cristalli Dioscoridi, Lorenzo Arlati, Sergio Molinari, Pietro Cintolo, Marcello Pugliese, Francesco Bonato, Giulia Forti, Edoardo Massimiliano, Mutignani Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience |
title | Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience |
title_full | Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience |
title_fullStr | Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience |
title_full_unstemmed | Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience |
title_short | Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience |
title_sort | non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: a single tertiary referral center experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009548/ https://www.ncbi.nlm.nih.gov/pubmed/35431757 http://dx.doi.org/10.4103/sja.sja_714_21 |
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