Conscious sedation is routinely used for endoscopie procedures Successful ERCP is dependent not only on the endoscopist's skills, but also on a cooperative and comfortable patient ERCP may require greater sedation than other endoscopie procedures, but little data is available regarding how much is commonly used. OBJECTIVE: To determine the drug requirements for conscious sedation during ERCP at two non-tertiary centers (VAMC and GSRMC) and one tertiary referral center (UMC). MATERIAL AND METHODS: ERCP procedure reports at 3 centers (GSRMC, VAMC and UMC) were reviewed over a 12-month period (12/93-11/94). Drugs and their dosages (mean ± SEM) in mg were tabulated The doses of benzodiazepines used were standardized by converting the midazolam dose to its equally potent diazepam dose (1 mg midazolam = 3 mg diazepam = Corrected). RESULTS: A total of 612 ERCPs were performed: 346 at GSRMC, 162 at VAMC and 104 at UMC, with the majority involving at least one gastroenterology fellow in training. The mean ages of patients at VAMC (59.5±0.8 yrs) were significantly greater than at GSRMC (52.7±0.9 yrs) and UMC (54.2±0.9 yrs) (p<0.05). The combination of a narcotic + benzodiazepine was the most commonly used drug regimen (77%), followed by benzodiazepine alone (13%). The mean doses of drugs used for conscious sedation at the 3 centers is depicted below Meperidine Diazepam Midazolam Corrected VAMC 92.8±3.4a,b 8.3±0.3a 0 8.3±0.3a,b GSRMC 69.9±2.5a,b 3.2±0.3a 4.2±0.1b 12.6±0.4a,b UMC 113.9±4.2b 0 9.5±0.4b 28.9±1.2b a,b p<0.05 (a: VAMC vs GSRMC; b: UMC vs GSRMC/VAMC) CONCLUSIONS: Significantly higher doses of both a narcotic and a benzodiazepine were used in at a tertiary referral center than either at a community hospital or VA medical center.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging