Comparison of hypnosis plus sedoanalgesia and sedoanalgesia alone methods used in the ERCP procedure: A prospective randomized study

Endoscopic retrograde cholangiopancreatography (ERCP) is an interventional procedure that is often performed under sedation anesthesia and that is used in the diagnosis and treatment of hepatopancreaticobiliary diseases. The objective of this study was to compare the efficacy of hypnosis in conjunction with sedoanalgesia and sedoanalgesia alone in the context of outpatient anesthesia prior to ERCP. Patients undergoing ERCP in the endoscopy unit between March and May 2021 were randomly assigned to 1 of 2 groups: group 1 received hypnosis and sedoanalgesia, and group 2 received sedoanalgesia alone. Both groups were administered 0.5 to 0.6 mg/kg intravenous pethidine hydrochloride (HCl), 1 to 3 mg intravenous midazolam, and 1 to 2 mg/kg intravenous propofol. The first group also received hypnotic induction before the procedure and anesthetic agents. In the event of patients exhibiting movement during the procedure, an anesthesiologist was unaware of the patient's allocation and administered additional propofol and/or pethidine HCl. A statistical comparison was conducted between the 2 groups regarding demographic data, vital parameters, medication requirements, and satisfaction scales. Thirty patients were included in both groups. Following the procedure, the administration of propofol and pethidine HCl was reduced in group 1 (P = .031 and P = .009, respectively). The 5-minute heart rate, baseline peripheral oxygen saturation at 3 and 10 minutes were lower in group 2 (P = .008, P = .011, P = .017, and P = .031, respectively). Although the dose of anesthetic drugs were lower, no significant difference was observed neither in the patient satisfaction scores, nor in patient movements. The use of hypnosis during ERCP enhances the efficacy of sedoanalgesia. Hypnotic anesthesia may be employed as an alternative method in cases where high-dose administration of these agents is contraindicated.