Table of Contents Author Guidelines Submit a Manuscript
Diagnostic and Therapeutic Endoscopy
Volume 2012, Article ID 639190, 5 pages
http://dx.doi.org/10.1155/2012/639190
Review Article

Propofol Sedation for ERCP Procedures: A Dilemna? Observations from an Anesthesia Perspective

Department of Anaesthesia, St. George’s Hospital, London SW17OQT, UK

Received 8 September 2011; Accepted 16 November 2011

Academic Editor: Tony C.K. Tham

Copyright © 2012 Davinder Garewal and Pallavi Waikar. 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

Propofol sedation for endoscopic retrograde cholangiopancreatography (ERCP) procedures is a popular current technique that has generated controversy in the medical field. Worldwide, both anesthetic and nonanesthetic personnel administer this form of sedation. Although the American and Canadian societies of gastroenterologists have endorsed the administration of propofol by nonanesthesia personnel, the US Food and Drug Administration (FDA) has not licensed its use in this manner. There is some evidence for the safe use of propofol by nonanesthetic personnel in patients undergoing endoscopy procedures, but there are few randomized trials addressing the safety and efficacy of propofol in patients undergoing ERCP procedures. A serious possible consequence of propofol sedation in patients is that it may result in rapid and unpredictable progression from deep sedation to general anesthesia, and skilled airway support may be required as a rescue measure. Potential complications following deep propofol sedation include hypoxemia and hypotension. Propofol sedation for ERCP procedures is an area of clinical practice where discussion and mutual cooperation between anesthesia and nonanesthesia personnel may enhance patient safety.