{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:16:31Z","timestamp":1794014191948,"version":"4.8.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Study Aim:<\/jats:title>\n                    <jats:p>Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral center for digestive endoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>Anesthesiological records, anamnestic, and intraoperative data of patients who underwent advanced therapeutic biliopancreatic endoscopies at our tertiary referral center from January 2019 until January 2020 were collected in the present observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>One hundred fifty-three patients (93 M; median age: 68-year-old; mean ASA status: 2) were considered eligible for a procedure in the prone position with GA in spontaneous breathing. Prone position was always the initial setting. Propofol administration through a target-controlled infusion (TCI) pump was the choice to achieve GA. In our experience, desaturation appears to be the most frequent adverse event, accounting for 35% of cases (55\/153). Treatment foresaw additional oxygen through a nasopharyngeal catheter, which proved to be a sufficient measure in almost all patients (52\/55). Other adverse events (i.e., inadequate sedative plan, pain, and bradycardia) accounted for 2.6% of cases (4\/153).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Non-intubated GA in the prone position may be regarded as a safe procedure, as long as the anesthesiological criteria of exclusion are respected and the anesthesiological team has become acquainted with the peculiar NORA setting and familiar with the management of possible adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_714_21","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T02:03:04Z","timestamp":1647568984000},"page":"150-155","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy"],"prefix":"10.4103","volume":"16","author":[{"given":"Valentina","family":"Melis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristalli","family":"Aldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Dioscoridi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Arlati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Molinari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Cintolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pugliese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Bonato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Forti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutignani","family":"Massimiliano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20240909","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.anclin.2017.08.006","article-title":"Anesthesia for routine and advanced upper gastrointestinal endoscopic procedures","volume":"35","author":"Sharp","year":"2017","journal-title":"Anesthesiol Clin"},{"key":"R3-2-20240909","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.gie.2017.07.018","article-title":"Guidelines for sedation and anesthesia in GI endoscopy","volume":"87","author":"Early","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"R4-2-20240909","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.giec.2016.02.007","article-title":"Non-operating room anesthesia in the endoscopy unit","volume":"26","author":"Bhavani","year":"2016","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"R5-2-20240909","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/ACO.0000000000000344","article-title":"Practical considerations in the development of a nonoperating room anesthesia practice","volume":"29","author":"Goudra","year":"2016","journal-title":"Curr Opin Anaesthesiol"},{"key":"R6-2-20240909","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.gie.2016.12.008","article-title":"Association of prophylactic endotracheal intubation in critically ill patients with upper GI bleeding and cardiopulmonary unplanned events","volume":"86","author":"Hayat","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"R8-2-20240909","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s10620-016-4375-z","article-title":"Airway management during upper GI endoscopic procedures: State of the art review","volume":"62","author":"Goudra","year":"2017","journal-title":"Dig Dis Sci"},{"key":"R9-2-20240909","doi-asserted-by":"crossref","first-page":"AB87","DOI":"10.1016\/j.gie.2006.03.047","article-title":"Bsg Audit of ERCP Steering Committee. 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Performance of the ASGE (Modified Schutz) scoring system in a prospectively studied cohort of 5264 procedures","volume":"63","author":"Williams","year":"2006","journal-title":"Gastrointest Endosc"},{"key":"R10-2-20240909","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/ACO.0b013e32832dba50","article-title":"The risk and safety of anesthesia at remote locations: The US closed claims analysis","volume":"22","author":"Metzner","year":"2009","journal-title":"Curr Opin Anaesthesiol"},{"key":"R11-2-20240909","doi-asserted-by":"crossref","first-page":"10398","DOI":"10.3748\/wjg.v22.i47.10398","article-title":"High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound","volume":"22","author":"Schumann","year":"2016","journal-title":"World J Gastroenterol"},{"key":"R12-2-20240909","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/EJA.0000000000000683","article-title":"European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults","volume":"35","author":"Hinkelbein","year":"2018","journal-title":"Eur J Anaesthesiol"},{"key":"R13-2-20240909","doi-asserted-by":"crossref","first-page":"400","DOI":"10.4103\/1319-3767.164202","article-title":"Cardiac arrests in patients undergoing gastrointestinal endoscopy: A retrospective analysis of 73,029 procedures","volume":"21","author":"Goudra","year":"2015","journal-title":"Saudi J Gastroenterol"},{"key":"R15-2-20240909","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1097\/ACO.0000000000000352","article-title":"Practical considerations in the management of sedation for colonoscopy","volume":"29","author":"Tetzlaff","year":"2016","journal-title":"Curr Opin Anaesthesiol"},{"key":"R16-2-20240909","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.giec.2016.02.002","article-title":"Training and competency in sedation practice in gastrointestinal endoscopy","volume":"26","author":"Da","year":"2016","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"R17-2-20240909","doi-asserted-by":"crossref","first-page":"E1296","DOI":"10.1055\/a-0603-3302","article-title":"Comparison of outcomes for supine vs.prone position ERCP: A systematic review and meta-analysis","volume":"6","author":"Mashiana","year":"2018","journal-title":"Endosc Int Open"},{"key":"R18-2-20240909","first-page":"150","article-title":"Prone position improves gas exchange--but how?","volume":"45","author":"Mure","year":"2001","journal-title":"Acta Anaesthesiol Scand"},{"key":"R19-2-20240909","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1007\/s10620-016-4043-3","article-title":"Efficacy and safety of propofol-mediated sedation for outpatient endoscopic retrograde cholangiopancreatography (ERCP)","volume":"61","author":"Yang","year":"2016","journal-title":"Dig Dis Sci"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_714_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:08:34Z","timestamp":1787166514000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_714_21"}},"subtitle":["A single tertiary referral center experience"],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_714_21","relation":{},"ISSN":["1658-354X"],"issn-type":[{"value":"1658-354X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}