Consensus guidelines for the perioperative management of patients undergoing endoscopic retrograde cholangiopancreatography

医学 全身麻醉 气管插管 镇静 围手术期 麻醉 内镜逆行胰胆管造影术 插管 重症监护医学 外科 胰腺炎
作者
Omid Azimaraghi,Mohammad Bilal,Somchai Amornyotin,Mustafa A. Arain,Matthias Behrends,Tyler M. Berzin,James Buxbaum,Curtis Choice,Philipp Faßbender,Mandeep Sawhney,Eswar Sundar,Karuna Wongtangman,Kate Leslie,Matthias Eikermann
出处
期刊:BJA: British Journal of Anaesthesia [Elsevier]
卷期号:130 (6): 763-772 被引量:7
标识
DOI:10.1016/j.bja.2023.03.012
摘要

Deep sedation without tracheal intubation (monitored anaesthesia care) and general anaesthesia with tracheal intubation are commonly used anaesthesia techniques for endoscopic retrograde cholangiopancreatography (ERCP). There are distinct pathophysiological differences between monitored anaesthesia care and general anaesthesia that need to be considered depending on the nature and severity of the patient's underlying disease, comorbidities, and procedural risks. An international group of expert anaesthesiologists and gastroenterologists created clinically relevant questions regarding the merits and risks of monitored anaesthesia care vs general anaesthesia in specific clinical scenarios for planning optimal anaesthetic approaches for ERCP. Using a modified Delphi approach, the group created practical recommendations for anaesthesiologists, with the aim of reducing the incidence of perioperative adverse outcomes while maximising healthcare resource utilisation. In the majority of clinical scenarios analysed, our expert recommendations favour monitored anaesthesia care over general anaesthesia. Patients with increased risk of pulmonary aspiration and those undergoing prolonged procedures of high complexity were thought to benefit from general anaesthesia with tracheal intubation. Patient age and ASA physical status were not considered to be factors for choosing between monitored anaesthesia care and general anaesthesia. Monitored anaesthesia care is the favoured anaesthesia plan for ERCP. An individual risk-benefit analysis that takes into account provider and institutional experience, patient comorbidities, and procedural risks is also needed.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
微笑凌瑶应助害羞的冰薇采纳,获得10
刚刚
小其发布了新的文献求助10
1秒前
1秒前
1秒前
2秒前
Megumi发布了新的文献求助10
2秒前
无花果应助甜丝丝采纳,获得30
3秒前
yaoxc给ZengQiu的求助进行了留言
3秒前
小Q啊啾发布了新的文献求助10
3秒前
一二三发布了新的文献求助20
4秒前
小巧凝丹完成签到,获得积分10
4秒前
菊花吗完成签到,获得积分10
4秒前
5秒前
优秀妙旋完成签到,获得积分10
5秒前
hangzi完成签到,获得积分10
5秒前
Dzhuo完成签到,获得积分10
5秒前
JOJO完成签到,获得积分10
5秒前
友好小小完成签到,获得积分10
6秒前
Cat完成签到,获得积分0
6秒前
zero灬发布了新的文献求助20
6秒前
王自信发布了新的文献求助10
6秒前
zhang发布了新的文献求助10
7秒前
7秒前
小鳄鱼发布了新的文献求助10
8秒前
tt完成签到,获得积分10
8秒前
Jay完成签到,获得积分20
8秒前
9秒前
Ann完成签到,获得积分20
9秒前
海绵宝宝发布了新的文献求助10
10秒前
10秒前
SKinner发布了新的文献求助10
11秒前
gqp完成签到,获得积分10
12秒前
12秒前
快乐东蒽完成签到,获得积分10
13秒前
13秒前
sunsun发布了新的文献求助10
14秒前
科目三应助活力千青采纳,获得10
14秒前
15秒前
斯文败类应助小Q啊啾采纳,获得10
15秒前
汉堡包应助小Q啊啾采纳,获得10
15秒前
高分求助中
Sustainability in Tides Chemistry 2000
The ACS Guide to Scholarly Communication 2000
Studien zur Ideengeschichte der Gesetzgebung 1000
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
Threaded Harmony: A Sustainable Approach to Fashion 810
Pharmacogenomics: Applications to Patient Care, Third Edition 800
A Dissection Guide & Atlas to the Rabbit 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3078453
求助须知:如何正确求助?哪些是违规求助? 2731120
关于积分的说明 7517197
捐赠科研通 2379609
什么是DOI,文献DOI怎么找? 1261760
科研通“疑难数据库(出版商)”最低求助积分说明 611719
版权声明 597349