Effect of sevoflurane anaesthesia on nasal mask in endoscopic retrograde cholangiopancreatography: is it a preferred alternative?

Abstract

Background/aim: Endoscopic retrograde cholangiopancreatography (ERCP) often requires deep sedation. Propofol provides adequatesedation and amnesia at subhypnotic doses, but safe guarding the patient’s airway is important for preventing respiratory depression orhypoxic events. This study compared sedation levels, operator satisfaction, intraoperative and recovery characteristics using sevofluranewith nasal mask and propofol in ERCP.Material and methods: Sixty-one patients underwent ERCP (Group I: propofol, n = 31; Group II, sevoflurane, n = 30), with sedationcontrolled by the Ramsay sedation scale (RSS). The patients’ demographic data, procedure length, overall drug dose, hemodynamicchanges, duration of recovery and Aldrete scores during recovery were evaluated. In addition, satisfaction of the gastroenterologist wasevaluated.Results: The mean sphincterotomy satisfaction scores were statistically significant (P= 0.043). The Aldrete scores and RSS of the groupswere similar; there was a significant difference between groups at the beginning of the procedure regarding peripheric oxygen saturationsand Group II’s saturation levels increased during sedation.Conclusion: In ERCP, propofol infusion provides shorter recovery duration and adequate sedation levels. Sevoflurane and oxygenwith a nasal mask can be chosen to generate specific anaesthesia in patients, especially for strong airway support and safety treatinghypoxemic patients.