Transcutaneous monitoring of partial pressure of carbon dioxide during endoscopic retrograde cholangiopancreatography using a double‐balloon endoscope with carbon dioxide insufflation under conscious sedation. Issue 3 (13th August 2013)

• Record Type: Journal Article
• Authors: Miyoshi, Hideaki; Shimatani, Masaaki; Kato, Kota; Sumimoto, Kimi; Kurishima, Akiko; Kusuda, Takeo; Fukata, Norimasa; Ikeura, Tsukasa; Takaoka, Makoto; Okazaki, Kazuichi
• Is Part Of: Digestive endoscopy. Volume 26:Issue 3(2014:May)
• Page Start: 436
• Page End: 441
• Publication Date: 2013-08-13
• Subjects: Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12155
• Languages: English
• ISSNs: 0915-5635

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="den12155-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>A double‐balloon (DB) endoscope can be selectively inserted into the afferent loop to carry out endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy, allowing various types of endoscopic treatments for pancreaticobiliary diseases to be successfully carried out. In order to make such a lengthy procedure more comfortable and safe, sedatives and carbon dioxide (CO<sub>2</sub>) insufflation are widely used for gastrointestinal endoscopy. However, these techniques can increase the risk of CO<sub>2</sub> retention. Recently, a new sensor for transcutaneous measurement of partial pressure of carbon dioxide (PCO<sub>2</sub>) has been introduced. The aim of the present study was to evaluate the changes in transcutaneous PCO<sub>2</sub> (PtcCO<sub>2</sub>) during DB‐ERCP with CO<sub>2</sub> insufflation under conscious sedation and assess any complications related to sedation and CO<sub>2</sub> insufflation.</p> </sec> <sec id="den12155-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 312 patients underwent DB‐ERCP with CO<sub>2</sub> insufflation at our hospital between March 2009 and December 2012. The patients were moderately sedated using midazolamwith or without pentazocine. PtcCO<sub>2</sub> was measured by a non‐invasive sensor throughout DB‐ERCP in all patients.</p> </sec> <sec id="den12155-sec-0003" sec-type="section"> <title>Results</title> <p>The mean peak PtcCO<sub>2</sub> during the procedure was significantly higher than the mean PtcCO<sub>2</sub> value before and after DB‐ERCP. Body mass index, procedure time and dose of pentazocine were significantly higher in the CO<sub>2</sub> retention group (peak PtcCO<sub>2</sub> ≥ 50 mmHg). CO<sub>2</sub> narcosis was observed in one case.</p> </sec> <sec id="den12155-sec-0004" sec-type="section"> <title>Conclusions</title> <p>DB‐ERCP with CO<sub>2</sub> insufflation under conscious sedation might have the potential to increase the risk of CO<sub>2</sub> retention. Hence, non‐invasive and continuous PtcCO<sub>2</sub> measurement is useful for early detection of hypercapnia.</p> </sec> </abstract>