Guidance for the use of propofol sedation for adult patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) and other complex upper GI endoscopic procedures


April 2011

On behalf of the Joint Royal College of Anaesthetists (RCoA) and British Society of Gastroenterology (BSG) Working Party.

Working Group:

Chair: Andy Tomlinson (RCoA)
Jonathan Green (BSG)
Stuart Cairns (BSG)
David Cressey (RCoA)
Ian Smith (RCoA)
John Peacock (AAGBI)


This guidance has been written because increasingly challenging diagnostic and therapeutic endoscopic procedures are being performed in adults and there is a need for more prolonged and satisfactory sedation to be administered; there is increasing evidence that this can be provided safely and appropriately by propofol when administered by those trained in its use. Sedation with propofol should be viewed as a completely separate entity from its use as a general anaesthetic.

These guidelines aim to cover UK practice in the use of propofol for sedation only in adult patients during endoscopic procedures, using ERCP as a specific example, as this group of patients can clearly benefit from the use of this drug administered by an appropriately trained anaesthetist or consultant anaesthetist supervised Physicians Assistant (Anaesthesia), so allowing the endoscopist to concentrate fully on the procedure. It is recognised that there are certain circumstances where general anaesthesia may be more appropriate, but these guidelines will not consider this further.

This guidance is to be added as an appendix to the Guidelines on Safety and Sedation for Endoscopic Procedures