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Anesthesiology Research and Practice
Volume 2013, Article ID 570518, 5 pages
http://dx.doi.org/10.1155/2013/570518
Research Article

Anesthesia for ERCP: Impact of Anesthesiologist's Experience on Outcome and Cost

1Department of Anesthesiology and Critical Care Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Strett, 680 Dulles, Philadelphia, PA 19104, USA
2Department of Anesthesia, All India Institute of Medical Sciences, New Delhi, India
3Department of Anaesthesia, Drexel University College of Medicine, University of Pennsylvania, Philadelphia, PA, USA

Received 1 April 2013; Revised 1 May 2013; Accepted 13 May 2013

Academic Editor: D. John Doyle

Copyright © 2013 Basavana G. Goudra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The present study evaluates the effect of anesthesiologist's experience in providing deep sedation for endoscopic retrograde cholangiopancreatography (ERCP) on cost and safety. Methodology. Perioperative records of 1167 patients who underwent ERCP were divided on the basis of anesthesiologist assisting these procedures either on regular basis (Group R) or on ad hoc basis (Group N). Comparisons were made for anesthesia times, complication rates, and airway interventions. Results. Across all American Society of Anesthesiologists (ASA) Classes, regular anesthesiologists were more efficient (overall mean anesthesia time in Group R was versus minutes in Group N). Within Group R, anesthesia times across all ASA classes were comparable. In Group N, anesthesia times for higher ASA status patients were significantly longer (ASA IV, versus ASA I, minutes). Intubation rates (0.76% versus 12.8%) and median minimal oxygen saturation (100% versus 97.01%) were significantly higher in Group R. Had Group R anesthesiologists performed all procedures, the hospital could have saved US $ 758536 (based upon operating room time costs). Conclusion. Experience in providing deep sedation improved patient safety and decreased the operating room turnaround time, thereby lowering operating room costs associated with these procedures.