title: Conscious sedation during endoscopic retrograde colangiopancreatography: implementation of SIED-SIAARTI-ANOTE guidelines in Belluno Hospital.
abstract: OBJECTIVE
  In this study we describe the results of adoption of local guidelines for conscious sedation (CS) during endoscopic-retrograde-cholangiopancreatography (ERCP) in Belluno Hospital. Local guidelines were created referring to SIED-SIAARTI-ANOTE guidelines for CS in gastrointestinal endoscopy.
  
  
  METHODS
  Between January 2002 and February 2004, 300 ERCPs to be performed under CS have been scheduled. According to local guidelines CS was performed by the gastroenterologist assisted by an anesthesia nurse. An anesthesiologist was always on call in the intensive care unit (ICU) for emergencies and could be on the site in less than 5 min.
  
  
  RESULTS
  In 278 patients the procedure was performed safely and effectively by the gastroenterologist without any anesthesiological assistance. At follow-up controls patients had either positive or no recollection of the procedure. An anesthesiologist was called in 13 cases to perform deep sedation and in 9 cases to deal with undesired effects (arterial hypertension in 5 patients, 1 episode of bradycardia, 1 of ventricular tachycardia, 1 of atrial fibrillation and 1 of hypoxia).
  
  
  CONCLUSIONS
  In our experience, CS during ERCP can be safely performed autonomously by a gastroenterologist in the majority of cases. Drug prescription protocol and the presence of an anesthesia nurse create ideal conditions for the operator, patient comfort and good results with a low incidence of undesired events and few calls for the anesthesiologist. To allow safe and effective performance of CS, the Department of Anesthesia should promote the in-service training and up dating of gastroenterologists and anesthesia nurses.
authors.affiliation: Department of Anesthesiology and Intensive Care, San Martino Hospital, Belluno.
authors.forename: D
authors.initials: D
authors.lastname: Mazzon
authors.forename: B
authors.initials: B
authors.lastname: Germanà
authors.forename: D
authors.initials: D
authors.lastname: Poole
authors.forename: M
authors.initials: M
authors.lastname: Celato
authors.forename: L
authors.initials: L
authors.lastname: Bernardi
authors.forename: G
authors.initials: G
authors.lastname: Calleri
authors.forename: F
authors.initials: F
authors.lastname: Fant
authors.forename: M
authors.initials: M
authors.lastname: Bernard
authors.forename: P
authors.initials: P
authors.lastname: Lecis
authors.forename: F
authors.initials: F
authors.lastname: Costan Biedo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003106:Colon / Q000000981:diagnostic imaging*; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging*