title: Anesthesia for endoscopic retrograde cholangiopancreatography: target-controlled infusion versus standard volatile anesthesia.
abstract: BACKGROUND
  Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specific complications. The primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay.
  
  
  METHODS
  Patients were randomized into two groups standard anesthesia group (Gr: SA) in whom induction was done by propofol, fentanyl and cisatracurium and maintenance was done by a mixture of oxygen, nitrousoxide (50%:50%) and sevoflurane; and intravenous anesthesia group to target concentration (Gr: TCI) in whom induction and maintenance of anesthesia were done with propofol with a target 0.5-2 μg/mL, and remifentanil with a target of 0.75-2 ng/mL.
  
  
  RESULTS
  90 patients were included. Extubation time was shorter in Gr: TCI, 15±2.6 vs. 27.4±7.1 min in Gr: SA (P<0.001). The incidence of hypotension was higher in GrL: SA (P=0.009). Satisfaction was better in Gr: TCI (P=0.003). Antispasmodic need was higher in Gr: SA (P=0.023). Six patients in Gr: SA group had desaturation in post-anesthesia care unit (PACU) versus one patient from Gr: TCI (P=0.049). Patients in Gr: TCI had shorter PACU stay 40.2±7.3 vs. 58.7±12.4 min (P<0.001).
  
  
  CONCLUSIONS
  The use of TCI mode allows better optimization of general anesthesia technique during ERCP.
authors.affiliation: Department of Anesthesiology and Critical Care, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy of Rabat, Mohamed V. University, Morocco.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Motiaa
authors.affiliation: Department of Anesthesiology and Critical Care, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy of Rabat, Mohamed V. University, Morocco.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Bensghir
authors.affiliation: Department of Anesthesiology and Critical Care, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy of Rabat, Mohamed V. University, Morocco.
authors.forename: Abdelhamid
authors.initials: A
authors.lastname: Jaafari
authors.affiliation: Department of Anesthesiology and Critical Care, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy of Rabat, Mohamed V. University, Morocco.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Meziane
authors.affiliation: Department of Anesthesiology and Critical Care, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy of Rabat, Mohamed V. University, Morocco.
authors.forename: Redouane
authors.initials: R
authors.lastname: Ahtil
authors.affiliation: Department of Anesthesiology and Critical Care, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy of Rabat, Mohamed V. University, Morocco.
authors.forename: Noureddine Drissi
authors.initials: ND
authors.lastname: Kamili
keywords: Endoscopic retrograde cholangiopancreatography; anesthesia intravenous target concentration; complications; general anesthesia; time of extubation