EVALUATING ERCP OUTCOMES: GENERAL ANESTHESIA VS. CONSCIOUS SEDATION IN A TERTIARY CARE SETTING

Abstract

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a critical technique for diagnosing and treating conditions affecting the biliary and pancreatic ducts. Recently, there has been a shift towards employing general anesthesia instead of conscious sedation for these interventions to enhance comfort and efficiency, particularly in intricate cases. This investigation evaluates the decision-making process behind general anesthesia over conscious sedation and assesses their comparative effectiveness and associated complication rates. Methods: Conducted as a retrospective cohort study at Akhtar Saeed Medical and Dental College Lahore, Pakistan, in the period from November 2023 to April 2024, this research involved 380 ERCP patients equally divided into two groups: one administered general anesthesia and the other, conscious sedation. Comprehensive data collection included patient demographics, specific criteria before the procedure, procedural details, and outcomes. The analysis utilized SPSS version 26.0, applying independent t-tests and chi-square tests for continuous and categorical variables, respectively, alongside logistic regression to pinpoint procedural outcomes and complications predictors. Results: Both the general anesthesia and conscious sedation groups, averaging ages of 55.2 and 54.8 years, respectively, showed no significant disparity in BMI, ASA scores, or reasons for ERCP. Success rates of the procedures did not significantly differ, standing at 85% for general anesthesia and 83% for conscious sedation, with complication rates at 20% and 18%, respectively. Metrics such as post-procedure pain, hospitalization duration, and patient satisfaction remained statistically similar across both groups. Conclusions: The study concludes that general anesthesia for ERCP is just as effective and safe as conscious sedation, with both methods showing equivalent success and complication rates. These results advocate for a tailored, patient-centric approach in selecting anesthesia techniques for ERCP, ensuring no procedural effectiveness or patient safety compromise.