Background ERCP is a complex endoscopic procedure which requires adequate sedation to increase patient tolerance and improve procedural success. Achieving the desired level of conscious sedation which allows for satisfactory completion of a therapeutic ERCP can be challenging. Few guidelines exist to support appropriate conscious sedation practice in ERCP.
Aim The aim of the study is to evaluate conscious sedation practices for ERCP in a single, tertiary referral centre in Dublin, Ireland.
Method A retrospective analysis was conducted for ERCPs performed from October 2014 to October 2016. ENDORAAD software was utilised to collect data.
Results 904 patients had ERCPs in Beaumont hospital under conscious sedation between 2014-2016. The median age was 65.6 (range 19-89). 419 were ≥70 years. The most frequently used benzodiazepine and opiate used for ERCPs in our review was diazepam (89% of all patients), and Fentanyl (96% of all patients). 51% of patients<70 years received more than one benzodiazepine or opiate, compared to 14.8% of patients≥70 years. In total 14 patients required reversal of sedation due to respiratory compromise, of which 11 were ≥70 years.
Conclusion The use of more than one benzodiazepine or opiate was more common in patients<70 years of age. Our data should be compared to that of other tertiary referral centres in Ireland, with the ultimate aim of developing guidelines for conscious sedation practice for ERCP.