Safety of same-day endoscopic ultrasound and endoscopic retrograde cholangiopancreatography under conscious sedation

Table 1 Patient demographics, indications, and procedure completion rates n (%)

	Tandem (group A) (n = 54)	EUS only (group B) (n = 56)	P-value1	ERCP only (group C) (n = 53)	P-value2
Demographics
Age (yr) (mean ± SD) (Range)	65.2 ± 15.6 (18-93)	63.4 ± 15.7 (19-85)	0.54	54.7 ± 21.3 (14-96)	0.004
Sex, male (%)	43%	66%	0.02	59%	0.12
Indications
Pancreatic mass	10 (19)	16 (29)	0.26	3 (6)	0.07
Cholangiocarcinoma	3 (6)	1 (2)	0.36	0 (0)	0.24
CBD stones	3 (6)	2 (4)	0.68	6 (11)	0.32
CBD stricture	1 (2)	10 (18)	0.01	1 (2)	1.00
Cholangitis	0	0	NA	8 (15)	NA
Abnormal imaging	10 (19)	10 (18)	1.00	2 (4)	0.03
Pancreatitis	4 (7)	4 (7)	1.00	1 (2)	0.36
Completion
Completion of procedures	EUS 54 (100)	56 (100)	1.00	46 (87)	0.56
	ERCP 49 (91)

¹P-value of group A vs group B;

²P-value of group A vs group C. EUS: Endoscopic ultrasound; ERCP: Endoscopic retrograde cholangiopancreatography; CBD: Common bile duct; NA: Not available.

Table 2 Sedation medication used and dosages n (%)

	Tandem (group A) (n = 54)	EUS only (group B) (n = 56)	P-value1	ERCP only (group C) (n = 53)	P-value2
Sedation type
Conscious sedation	52 (96)	56 (100)	0.24	52 (98)	0.22
GA/propofol	2 (4)	0	0.24	1 (2)	0.22
Medications used for sedation
Meperidine	49 (91)	56 (100)	0.03	44 (83)	0.27
Midazolam	54 (96)	56 (100)	0.24	53 (98)	1.00
Diphenhydramine	16 (30)	4 (7)	0.003	28 (53)	0.02
Promethazine	5 (9)	4 (7)	0.74	0	0.06
Fentanyl	7 (13)	0	0.01	8 (15)	0.12
Total dosage of sedatives used (mean ± SD) (range)
Meperidine (mg)	151.1 ± 64 (25-325)	104 ± 43.6 (25-250)	< 0.0001	104.5 ± 32.5 (25-175)	< 0.0001
Midazolam (mg)	8.5 ± 3.2 (0-16)	6.3 ± 2.4 (2-13)	0.0001	6.9 ± 3.4 (0-16)	0.01
Diphenhydramine (mg)	50 ± 15.8 (25-100)	50 ± 0 (50)	1.00	51.8 ± 9.45 (50-100)	0.64
Promethazine (mg)	25 ± 0 (25)	25 ± 0 (25)	1.00	0	NA
Fentanyl (mcg)	100.0 ± 55.9 (25-175)	0	NA	146.9 ± 54.2 (75-200)	0.12

¹P-value of group A vs group B;

²P-value of group A vs group C. GA: General anesthesia.

Table 3 Procedure and recovery times (mean ± SD) (range)

	Tandem (group A) (n = 54)	EUS only (group B) (n = 56)	P-value1	ERCP only (group C) (n = 53)	P-value2
EUS time (min)	48 ± 28 (8-110)	59 ± 35 (10-129)	0.07	NA	NA
ERCP time (min)	45.1 ± 20.7 (10-105)	NA	NA	40.1 ± 20.4 (7-90)	0.20
EUS and ERCP time (min)	93.5 ± 36.1 (30-185)	NA	NA	NA	NA
Recovery time (min)	105.1 ± 74.8 (15-350)	84.0 ± 51.7 (9-252)	0.06	84.5 ± 42.6 (20-170)	0.07

¹P-value of group A vs group B;

²P-value of group A vs group C.

Table 4 Procedure complications n (%)

	Tandem (group A) (n = 54)	EUS only (group B) (n = 56)	P-value1	ERCP only (group C) (n = 53)	P-value2
Hypotension	4 (7)	7 (13)	0.53	3 (6)	1.00
Bradycardia	12 (22)	14 (25)	0.82	14 (26)	0.66
Desaturation	1 (2)	0	NA	3 (6)	0.36
Use of reversal agent	2 (4)	0	NA	2 (4)	1.00
Post procedure pancreatitis	2 (4)	0	NA	4 (8)	0.68
Hospitalization	1 (2)	0	0.49	2 (4)	0.62

¹P-value of group A vs group B;

²P-value of group A vs group C.