Conscious sedation as a potential optimal anesthetic regimen for endoscopic retrograde cholangiopancreatography in elderly frail patients: A prospective, single-blind, randomized controlled trial.

Li C, Zeng N, Wang F, Zhang Y, Ma D, Hou H.

research-articleOpen access

AI summary — for doctors, generated from the abstract only

In a randomised trial of elderly frail patients undergoing emergency ERCP, conscious sedation resulted in significantly fewer adverse cardiovascular events than intravenous general anesthesia (17% vs 40%), along with more stable blood pressure and heart rate.

What was studied

A single-center, prospective, single-blind, randomized controlled trial comparing conscious sedation versus intravenous general anesthesia in 108 patients aged 70-90 undergoing emergency endoscopic retrograde cholangiopancreatography (ERCP), assessing the incidence of adverse cardiovascular events (ACVs) and procedural adverse reactions, along with patient, anesthesiologist, and endoscopist satisfaction.

Key findings

108 patients were randomized to conscious sedation (n=53) or intravenous general anesthesia (n=55).
The incidence of adverse cardiovascular events was significantly lower in the conscious sedation group than the general anesthesia group (17% vs 40%).
Conscious sedation reduced fluctuations in blood pressure and heart rate compared with general anesthesia; specific statistical values for the hemodynamic comparisons and satisfaction outcomes were not fully detailed in the provided abstract text.

Clinical relevance

This may be relevant to anesthesiologists managing elderly frail patients for emergency ERCP, suggesting conscious sedation could be a safer anesthetic approach than general anesthesia in this high-risk population by reducing cardiovascular complications and hemodynamic instability.

Who should care

Anaesthesiology

Limitations

This was a single-center, single-blind (not double-blind) trial with a modest sample size (108 patients), which may limit generalisability; specific statistical significance values for several secondary comparisons were not fully available in the provided abstract text.

Conscious sedation more than halved the rate of cardiovascular complications compared with general anesthesia in elderly frail patients undergoing emergency ERCP.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Objective

To investigate the impact of adverse cardiovascular events (ACVs) in elderly frail patients undergoing emergency endoscopic retrograde cholangiopancreatography (ERCP), and to explore a safe and comfortable anesthetic regimen suitable for this specific population.

Materials and methods

A single-center, prospective, single-blind, randomized controlled trial was conducted. Patients aged 70-90 years scheduled for emergency ERCP were enrolled and randomly divided into two groups: the conscious sedation group (Group S) and the intravenous general anesthesia group (Group A). Basic clinical data of the patients were recorded. During ERCP, the occurrence of ACVs was documented, including hemodynamic fluctuations exceeding 20% of the baseline value, angina pectoris, myocardial infarction, cardiac arrest, acute heart failure, myocardial ischemia, pulmonary embolism, and various arrhythmias. Additionally, adverse reactions such as hypoxemia, body movement, and cough during the procedure were monitored. The effects of different anesthetic methods on ACVs in elderly frail patients undergoing emergency ERCP were compared, and the satisfaction of patients, anesthesiologists, and endoscopists was evaluated.

Results

A total of 108 patients undergoing emergency ERCP were enrolled and randomly assigned to Group S (n = 53) and Group A (n = 55). The results showed that there was a statistically significant difference in the incidence of ACVs between the two groups (17% vs. 40%, P P P < 0.05).

Conclusion

Compared with intravenous general anesthesia, conscious sedation can reduce fluctuations in blood pressure and heart rate, and decrease the incidence of adverse cardiovascular events in elderly frail patients undergoing emergency ERCP.

DOI

10.4103/sja.sja_94_26

PMID

42553904

PMCID

PMC13436862

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

Want more like this?

Browse more from the feed. A free account unlocks the full feed, saving and communities.

Back to the research feed

Create a free account · Sign in