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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

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Related Experiment Video

Updated: Jun 4, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Does anesthesiologist-directed sedation for ERCP improve deep cannulation and complication rates?

Paresh P Mehta1, John J Vargo, John A Dumot

  • 1Department of Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.

Digestive Diseases and Sciences
|January 29, 2011
PubMed
Summary

Gastroenterologist-directed sedation (GDS) and anesthesiologist-directed sedation (ADS) for endoscopic retrograde cholangiopancreatography (ERCP) showed similar deep cannulation success rates. Complication rates were also comparable between the two sedation approaches in this study.

Related Experiment Videos

Last Updated: Jun 4, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Area of Science:

  • Gastroenterology
  • Anesthesiology
  • Medical Procedures

Background:

  • Sedation for endoscopic retrograde cholangiopancreatography (ERCP) can be managed by gastroenterologists or anesthesiologists.
  • Limited data exists comparing deep cannulation success and complication rates between these two sedation approaches.
  • Anesthesiologist-directed sedation (ADS) theoretically may improve deep cannulation due to consistent sedation levels and dedicated monitoring.

Purpose of the Study:

  • To compare the success rates of deep cannulation during ERCP.
  • To evaluate procedural complication rates between gastroenterologist-directed sedation (GDS) and ADS.
  • To determine if sedation provider impacts ERCP outcomes.

Main Methods:

  • A retrospective review of ERCPs performed by senior endoscopists over two years.
  • Sedation was managed by GDS (narcotic and benzodiazepine) in year one and ADS in year two.
  • Patients with prior papillary interventions were excluded; deep cannulation success and complications were recorded.

Main Results:

  • A total of 367 patients were analyzed: 178 (48.5%) under GDS and 189 (51.5%) under ADS.
  • No significant differences were observed in demographics between the GDS and ADS groups.
  • Overall cannulation success rates were similar (94.4% GDS vs. 95.2% ADS, P=0.36), with comparable complication profiles.

Conclusions:

  • Deep ductal cannulation rates during ERCP are similar regardless of whether sedation is provided by gastroenterologists or anesthesiologists.
  • The choice of sedation provider (GDS vs. ADS) does not appear to significantly impact ERCP deep cannulation success.
  • Complication rates were also comparable between the GDS and ADS groups.