Iram Riaz, Aftab Haider Alvi, Aijaz Zeeshan Khan Chachar, Raheel Pervaiz, Bushra Ali, Arif Amir Nawaz.
Deeper Sedation by Anesthesia Staff Results in Improved Procedural Outcome and Enhances patient Safety - a Comparison of ERCP outcomes with conscious sedation and monitored anesthesia care.
Pak J Med Health Sci Jan ;12(1):359-61.

Aim : To assess the outcome of ERCP with conscious sedation and monitored anesthesia care and compare the complication rate at various stages of anesthesia. Place of study: Department of Gastroenterology and Hepatology, Fatima Memorial Hospital Shadman, Lahore . Study design: Cross Sectional study. Methods: We collected data on outcomes including cannulation rate, completion of desired treatment and rate of complications in 109 patients 48 (44%) patients undergoing the procedure with conscious sedation using a benzodiazepine and narcotic combination administered by the nursing staff and 61 (56%) patients with monitored anesthesia care (MAC) administered by the anesthesia staff. Results: A total of 109 patients were included in this study. 48/109 (44%) of the patients underwent ERCP under conscious sedation while 61/109 (56%) underwent the same procedure with MAC. Overall success rate of the procedure as defined by completion of the desired treatment was 78% with a 63% completion rate in the conscious sedation group and a 92% completion rate in the MAC group. Conclusion: MAC results in improved procedural outcomes including success of cannulation and completion of desired treatment when compared to conscious sedation. Patients undergoing ERCP under MAC also have a much lower complication rate.

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