Saudi Journal of Anaesthesia

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 16  |  Issue : 2  |  Page : 150--155

Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience


Valentina Melis1, Cristalli Aldo1, Lorenzo Dioscoridi2, Sergio Arlati1, Pietro Molinari1, Marcello Cintolo2, Francesco Pugliese2, Giulia Bonato2, Edoardo Forti2, Mutignani Massimiliano2 
1 Department of Anesthesiology, Intensive Care Unit, ASST Niguarda, Milan, Italy
2 Department of Surgery, Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy

Correspondence Address:
Lorenzo Dioscoridi
Digestive and Interventional Endoscopy Unit, ASST Niguarda, Piazza dell'Ospedale Maggiore 3, 20162, Milan
Italy

Background and Study Aim: Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral center for digestive endoscopy. Patients and Methods: Anesthesiological records, anamnestic, and intraoperative data of patients who underwent advanced therapeutic biliopancreatic endoscopies at our tertiary referral center from January 2019 until January 2020 were collected in the present observational study. Results: One hundred fifty-three patients (93 M; median age: 68-year-old; mean ASA status: 2) were considered eligible for a procedure in the prone position with GA in spontaneous breathing. Prone position was always the initial setting. Propofol administration through a target-controlled infusion (TCI) pump was the choice to achieve GA. In our experience, desaturation appears to be the most frequent adverse event, accounting for 35% of cases (55/153). Treatment foresaw additional oxygen through a nasopharyngeal catheter, which proved to be a sufficient measure in almost all patients (52/55). Other adverse events (i.e., inadequate sedative plan, pain, and bradycardia) accounted for 2.6% of cases (4/153). Conclusions: Non-intubated GA in the prone position may be regarded as a safe procedure, as long as the anesthesiological criteria of exclusion are respected and the anesthesiological team has become acquainted with the peculiar NORA setting and familiar with the management of possible adverse events.


How to cite this article:
Melis V, Aldo C, Dioscoridi L, Arlati S, Molinari P, Cintolo M, Pugliese F, Bonato G, Forti E, Massimiliano M. Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience.Saudi J Anaesth 2022;16:150-155


How to cite this URL:
Melis V, Aldo C, Dioscoridi L, Arlati S, Molinari P, Cintolo M, Pugliese F, Bonato G, Forti E, Massimiliano M. Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy: A single tertiary referral center experience. Saudi J Anaesth [serial online] 2022 [cited 2022 May 19 ];16:150-155
Available from: https://www.saudija.org/article.asp?issn=1658-354X;year=2022;volume=16;issue=2;spage=150;epage=155;aulast=Melis;type=0