title: Anesthesiologist assistance in endoscopic retrograde cholangiopancreatography procedures in the elderly: is it worthwhile?
abstract: BACKGROUND
  Anesthesiologists provide sedation of the patients for mini-invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP) at many institutions at present, particularly for the elderly. The purpose of the present study was to define the safety of sedation and the tolerance of ERCP procedures in the extremely elderly patients at our institution, in which sedation is provided and controlled by endo team only.
  
  
  METHODS
  Forty-one ERCP procedures were performed in patients aged 90 years or older. All patients had chronic concomitant diseases, and 88% of the patients belonged to American Society of Anesthesiologists group IV. The patients were sedated with midazolam, and 7 out of 41 patients received fentanyl.
  
  
  RESULTS
  All ERCP procedures except one could be successfully completed, indicating good tolerance in 98% of the patients. There were neither sedation-related complications nor procedural mortality. In none of the cases, anesthesiologist assistance was needed.
  
  
  CONCLUSIONS
  Routine anesthesiological assistance in ERCP procedures in the elderly seems unnecessary.
authors.affiliation: Departments of Surgery and Emergency, University of Turku, Turku, Finland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Salminen
authors.forename: Juha M
authors.initials: JM
authors.lastname: Grönroos
mesh_terms: D000369:Aged, 80 and over; D000698:Analgesia; D000776:Anesthesiology; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D054810:Deep Sedation; D005260:Female; D006801:Humans; D008297:Male