Anesthetic Management during Percutaneous Endoscopic Gastrostomy

  Objective  To summarize the clinical experience in anesthetic management during percutaneous endoscopic gastrostomy (PEG).

  Methods  The clinical data of 90 patients with PEG in our hospital were analyzed retrospectively. Their anesthetic methods, intravenous anesthetic drugs, and anesthetic risks were summarized.

  Results  A total of 85 patients underwent topical anesthesia + local anesthesia + intravenous sedation or general anesthesia, among whom only one patient was treated with endotracheal intubation under general anesthesia while five patients with topical anesthesia + local anesthesia. The main intravenous anesthetic drugs included midazolam, fentanyl (or sufentanil), and propofol (or etomidate), with different medication dosages. The hemodynamic and respiratory changes were basically stable during PEG, while adverse events such as hypoxemia, hypertention, and bradycardia occurred occasionally. The minimal systolic and diastolic blood pressures and heart rate decreased significantly and the maximal oxygen saturation by pulse oximetry increased significantly during PEG compared with those before PEG (all P < 0.05).

  Conclusion  PEG can be carried out under topical anesthesia + local anesthesia + intravenous sedation or general anesthesia; nevertheless, anesthetic management should be emphasized.