Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement
Anesthesia Implications
Position: Supine, arms free at side
Time: 30-60 min (short)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: No
Anesthetic Approaches
- MAC
- GETT
The Pathophysiology
The patient is not or cannot receive necessary nutrition PO. PEG tube placement is done to provide a direct route for nutrition and drugs.
The Surgery
This procedure is aided by endoscopy. The endoscope is inserted and advanced to the stomach. The stomach is then insufflated which brings it closer to the abdominal wall. A needle is inserted percutaneously, followed by a guide wire, and then the PEG tube. All is done while viewing with the endoscope.
References: Oxford Medical Publications. Oxford handbook of anesthesia. 4th edition. 2016. Jaffe. Anesthesiologist’s manual of surgical procedures. 15th edition. 2014.
