Comparison of the effects of general anesthesia and deep sedation on anesthesia complications and mortality in endoscopic retrograde cholangiopancreatography procedures

Abstract

Introduction: Endoscopic retrograde cholangiopancreatography is extremely painful and uncomfortable when performed without anesthesia. However, the type of anesthesia to be applied remains a matter of debate. In this study, general anesthesia and sedation procedures were compared in endoscopic retrograde cholangiopancreatography performed by the same anesthesia and surgical team over a 5-year period. Materials and Method: Patients aged over 65 years were divided into two groups, general anesthesia and sedation, and their data were analyzed retrospectively. Anesthesia complications, surgical complications, duration of the procedure, need for intensive care, and length of hospital stay and intensive care needs were compared between groups in 2812 patients. Results: Data from 1885 patients were analyzed. The procedure time and hospital stay were shorter, and anesthesia-related complication rate was lower in the general anesthesia group. Although not statistically significant, mortality was higher, and the need for intensive care was similar to the sedation group. The complication rate significantly increased in patients aged over 75 years Conclusion: Endoscopic retrograde cholangiopancreatography can be performed under deep sedation or general anesthesia. The experience of the anesthetist is an important factor for this choice. The use of sedation in geriatric patients is associated with more complications that require airway interventions. In addition, anesthesia complications due to prolonged procedures were more common in the sedation group. Conclusion: In our study, it was observed that general anesthesia was safer for endoscopic retrograde cholangiopancreatography procedures performed in geriatric patients by an experienced anesthesia and surgical team.