[Minimal Sedation in Endoscopic Retrograde Cholangiopancreatography Supervised by Endoscopists: Experience in Venezuelan Patients].

Abstract

Introduction: The use of sedation in digestive endoscopy, particularly in endoscopic retrograde cholangiopancreatography, improves patient tolerance to the procedure and facilitate optimal endoscopic examination conditions, thereby achieving the desired diagnostic and therapeutic effect. Fentanyl and diazepam have been used for years as intravenous medication for upper gastrointestinal endoscopy.

Objective: To evaluate the safety of sedation with diazepam and fentanyl, under the supervision of endoscopists, during endoscopic retrograde cholangiopancreatography.

Material and methods: Descriptive, cross-sectional and prospective study conducted in patients who underwent endoscopic retrograde cholangiopancreatography under sedation with diazepam (5 to 15 mg) and fentanyl (25 to 50 µg) between July 2014 and June 2024. Oxygen saturation, blood pressure and heart rate were monitored to determine the occurrence of adverse events attributable to sedation.

Results: 12,686 patients were studied with an average age of 52.5 years. Hypoxemia was the most frequent complication (85 patients, 0.7%), followed by bradycardia (54 patients,0.4%) and arterial hypotension (41 patients, 0.3%).

Conclusions: Diazepam and fentanyl, administered by trained endoscopist physician and nurse, represent a safe anesthetic alternative for endoscopic retrograde cholangiopancreatography. It allows procedures to be performed outside the operating room, thereby reducing costs.