Anaesthesia Concerns for Gastrointestinal Endoscopic Procedures

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a unique diagnostic and therapeutic procedure performed in high-risk patients in prone/semi-prone positions. ERCP has evolved from a simple diagnostic procedure performed under endoscopist-administered sedation to a therapeutic one involving increasingly complex techniques. The anaesthesiologist has become a vital member of the team. Complex interventional gastrointestinal endoscopy procedures are challenging due to high-risk patient profiles, non-operating room set-up, non-supine position, space restrictions, prolonged duration, and airway sharing-related issues. These procedures require deep sedation or general anaesthesia to be administered to the patient, and vigilant airway management is of utmost importance. However, there is a significant lack of literature on recommendations regarding specific anaesthesia techniques. This gap in knowledge can have implications for patient safety and procedural ease. Therefore, it is crucial to increase awareness of anaesthetic concerns for these challenging non-operating room procedures, allowing the anaesthetist to select an appropriate technique to provide safe and effective anaesthesia and optimise patient outcomes. Our objective is to delve into the various anaesthesia techniques utilised and review the unique challenges these procedures pose in remote anaesthesia settings.
Keywords: Anaesthesia; anaesthesia safety in endoscopic procedures; conscious sedation; developing nations; gastrointestinal endoscopy.